A Multi-Institutional Propensity Score Matched Comparison of Transperitoneal and Retroperitoneal Partial Nephrectomy for cT1 Posterior Tumors

Abstract Objective: To compare the perioperative and renal functional outcome between transperitoneal and retroperitoneal robotic partial nephrectomy (TP-RPN and RP-RPN) in the largest cohort to date of RP-RPN for posterior tumors. Methods: We identified 519 patients who met eligibility criteria and underwent TP-RPN (n = 357, 68.8%) or RP-RPN (n = 162, 31.2%) for a posteriorly located cT1 tumor. Patients were propensity score (PS) matched on preoperative and tumor-specific characteristics. Perioperative outcome and renal function outcome at median follow-up 22 months were compared. Results: Between the PS matched TP-RPN (n = 157, 50%) and RP-RPN (n = 157, 50%) patients, operative time (OT) (185.0 versus 157.0, P < .001) was longer in TP-RPN versus RP-RPN patients. No significant differences in ischemia time (P = .618), blood loss (P = .178), positive surgical margins (P = .501), overall postoperative complications (P = .861), or progression of chronic kidney disease stage at median 22 months (P = .599) we...