title: Laparoscopic nephrectomy for polycystic kidney: comparison of the transperitoneal and retroperitoneal approaches.
abstract: OBJECTIVE
  To evaluate and compare perioperative outcomes in patients undergoing either transperitoneal (TP) or retroperitoneal (RP) laparoscopic nephrectomy for autosomal dominant polycystic kidney disease (ADPKD).
  
  
  METHODS
  All patients with ADPKD who underwent unilateral laparoscopic nephrectomy between 2000 and 2012 in two academic departments were retrospectively included. The perioperative parameters were compared between the TP and RP groups.
  
  
  RESULTS
  A total of 82 patients were included, 43 patients in the TP group and 39 in the RP group. The patients' characteristics were similar between TP set and RP set, except for the time from dialysis onset to nephrectomy (p = 0.02). Complication rates (25.6 vs 33.3 %, p = 0.44), transfusion rates (11.6 vs 20.5 %, p = 0.27) and conversion to open surgery (4.6 vs 7.7 %, p = 0.56) were similar between the TP and RP groups, respectively. Operative time was shorter for TP procedures (171.6 vs 210.5 min, p = 0.002), but there was no difference between the two approaches after 20 surgeries (p = 0.06). Patients in TP group had a shorter length of hospital stay (5.3 ± 1.9 vs 7.2 ± 2.5 days, p = 0.002). However, there was a trend towards shorter return of bowel function in the RP group (2.1 ± 0.9 vs 2.4 ± 0.8 days, p = 0.09).
  
  
  CONCLUSIONS
  TP and RP laparoscopic nephrectomies provide good outcomes in patients with ADPKD. The choice of a TP route could decrease the length of hospital stay and the operative time during the beginning of the learning curve period.
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rangueil-Toulouse, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France. thibaut.benoit31@gmail.com.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Benoit
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rennes, Rennes, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Peyronnet
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rangueil-Toulouse, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Roumiguié
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rennes, Rennes, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Verhoest
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rangueil-Toulouse, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Beauval
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rennes, Rennes, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Delreux
authors.affiliation: Department of Nephrology, CHU Rangueil-Toulouse, Toulouse, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Chauveau
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rangueil-Toulouse, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Malavaud
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rennes, Rennes, France.
authors.forename: Andréa
authors.initials: A
authors.lastname: Manunta
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rangueil-Toulouse, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Soulié
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rangueil-Toulouse, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Rischmann
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rangueil-Toulouse, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
authors.affiliation: Department of Urology, Andrology and Renal Transplantation, CHU Rangueil-Toulouse, 1 Avenue du Professeur Jean Poulhes, 31059, Toulouse, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Gamé
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010537:Peritoneum; D016891:Polycystic Kidney, Autosomal Dominant / Q000601:surgery*; D012187:Retroperitoneal Space; D012189:Retrospective Studies
keywords: Laparoscopy; Nephrectomy; Polycystic kidney disease; Retroperitoneal; Transperitoneal