title: A Modified Retroperitoneoscopic Technique in Supine Position for Primary Retroperitoneal Tumors: Technique and Clinical Outcomes.
abstract: To assess the feasibility and safety of a modified retroperitoneoscopic technique in supine position for the primary tumors located below the level of renal pedicle.
  
  
  
  In this retrospective study, 27 patients with primary retroperitoneal tumors located below the level of renal pedicle were recruited from January 2009 till now. The mean age of patients was 49.0 years (36-66 years). The average body mass index was 21.1 ± 1.4 kg/m(2). The retroperitoneoscopic resections were performed in supine position for all patients. The perioperative outcomes were collected and analyzed.
  
  
  
  All cases were performed by the modified technique without converting to open surgery. The mean operation time was 98.3 ± 12.8 min, with a mean estimated blood loss of 94.4 ± 42.5 mL. There were four patients suffering from intraoperative complications, one with the inferior vena cava (IVC) injury, one with the lumbar vein injury, and other two with the peritoneum breach. Postoperatively, the median bowel recovery time was 2 days (range: 1-3 days), and the mean length of stay after operation was 2.9 ± 1.0 days. Additionally, compared with the tumors located around the aorta (region B), a longer operation time was needed with tumors located around the IVC (region A) (A vs B: 105.8 ± 10.2 vs 91.2 ± 14.4, p = 0.02). Histopathology confirmed paraganglioma in 5 cases, schwannoma in 10 cases, and ganglioneuroma in 12 cases. After follow-up of 12-72 months, no recurrences have been identified.
  
  
  
  Our modified retroperitoneoscopic technique in supine position was proven to be safe and effective for the treatment of primary retroperitoneal tumors, especially suitable for the tumors located below the level of the renal pedicle.
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Shaobo
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Qiang
authors.initials: Q
authors.lastname: Cao
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Pu
authors.initials: P
authors.lastname: Li
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Jian
authors.initials: J
authors.lastname: Qian
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Chao
authors.initials: C
authors.lastname: Qin
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Pengfei
authors.initials: P
authors.lastname: Shao
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lv
authors.affiliation: Department of Urology, The First Affiliated Hospital of Nanjing Medical University , Nanjing, China .
authors.forename: Zengjun
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D061887:Conversion to Open Surgery; D005260:Female; D005729:Ganglioneuroma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D061646:Operative Time; D010235:Paraganglioma / Q000473:pathology / Q000601:surgery*; D056888:Patient Positioning / Q000379:methods*; D010537:Peritoneum / Q000293:injuries; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D016683:Supine Position; D047368:Tumor Burden; D014682:Vena Cava, Inferior / Q000293:injuries