title: Transperitoneal versus retroperitoneal laparoscopic nephroureterectomy in the management of upper urinary tract urothelial carcinoma: a matched-pair comparison based on perioperative outcomes.
abstract: Radical nephroureterectomy is considered as the gold standard for the surgical treatment of upper urinary tract urothelial carcinoma (UTUC). Laparoscopic radical nephroureterectomy (LNU) can be performed via the transperitoneal (TLNU) or retroperitoneal (RLNU) approach, and each one has its own advantages and limitations. Our study was conducted to describe the difference between TLNU and RLNU by comparing the perioperative outcomes.
  
  
  
  From January 2009 to October 2014, 68 patients underwent TLNU or RLNU at our center were retrospectively collected and 1:1 matched for age, body mass index and tumor side. Baseline characteristics and perioperative outcomes were evaluated and compared, respectively.
  
  
  
  There were no significant differences between the TLNU and RLNU group in terms of baseline characteristics, operating time, estimated blood loss, visual analogue pain scale, cosmetic results, intraoperative and postoperative complication rate. Compared to TLNU approach, RLNU was associated with a quicker time to first oral intake (2.9 vs 2.0 days, p = 0.02) and hospital discharge (6.7 vs 5.6 days, p = 0.02).
  
  
  
  Both transperitoneal and retroperitoneal laparoscopic approaches are safe and effective methods for treatment of UTUC. Retroperitoneal approach has the advantage in terms of quicker bowel recovery and shorter hospital discharge.
authors.affiliation: Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China.
authors.forename: Yinhuai
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Zhong
authors.affiliation: Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China.
authors.forename: Hongyi
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China.
authors.forename: Shifeng
authors.initials: S
authors.lastname: Ouyang
authors.affiliation: Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China. zhuliang_xy2yy@163.com.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China.
authors.forename: Ran
authors.initials: R
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010537:Peritoneum / Q000601:surgery; D012187:Retroperitoneal Space / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000601:surgery*
keywords: Laparoscopic; Nephroureterectomy; Retroperitoneal; Transperitoneal; Upper urinary tract urothelial carcinoma