Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/11641
Retroperitoneoscopic approach for highly complex posterior renal hilar tumors
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ISSN: 1677-5538
eISSN: 1677-6119
WOS ID: 000530043300037
Scopus EID: 2-s2.0-85082096579
PMID: 32167727
Embase PUI: L631238716
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2020-05Document type
editorialCitation
Bauza JL, Tubau V, Guimera J, Ladaria L, Aliaga C, Piza P, et al. Retroperitoneoscopic approach for highly complex posterior renal hilar tumors [editorial]. Int Braz J Urol. 2020 May;46(3):485-6.Abstract
Objectives: To show our single-center experience in retroperitoneoscopic approach for highly complex posterior hilar tumors. Minimally invasive nephron sparing surgery for renal hilar tumors is extremely challenging due to their anatomic location, close to the main renal vessels and the collecting system (1). Transperitoneal approach is feasible, but highly complex because the anterior disposition of the vasculature. Retroperitoneal approach can easily provide access to the posterior hilar structures and the posterolateral surface of the kidney(2, 3). Materials and Methods: We retrospectively reviewed our hilar renal tumor database and analyzed those in which a retroperitoneoscopic approach was chosen. The RENAL score was then calculated, and operative and ischemia times were recorded. We also collected the mean hospital stay and the presence of complications. Pathology reports and follow-up were also gathered. Results: Five of our twelve highly complex hilar renal tumor patients were treated using a retroperitoneoscopic approach. Mean RENAL score was 10. Mean operative time was 135 minutes. Mean warm ischemia time was 14 minutes. Mean hospital stay was 4 days. We have recorded 2 complications. One patient required a transfusion and another presented with an urinary fistula which was treated by double J stent placement. The pathology report showed a clear cell renal cell carcinoma pT1a in most of the cases. Only one patient had a positive margin. To date, no recurrences have been noticed. Conclusions: The treatment of complex renal hilar tumors in a minimally invasive fashion is highly challenging even in experienced hands. Retroperitoneal partial nephrectomy is feasible, safe and effective for the treatment of such lesions. Long-term oncologic outcomes of this approach are awaited.