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Multi-institutional feasibility and safety outcomes of retroperitoneal robot-assisted partial nephrectomy in morbidly obese patients
Journal article   Open access   Peer reviewed

Multi-institutional feasibility and safety outcomes of retroperitoneal robot-assisted partial nephrectomy in morbidly obese patients

Ian Mitchell McElree, Aaron Christopher Smith, Goran Rac, Hiten Patel, Gopal Gupta and Paul Thomas Gellhaus
Translational andrology and urology, Vol.12(5), pp.700-707
05/01/2023
DOI: 10.21037/tau-22-829
PMCID: PMC10251096
PMID: 37305642
url
https://doi.org/10.21037/tau-22-829View
Published (Version of record) Open Access

Abstract

Background: Robotic-assisted partial nephrectomy (RAPN) is an established treatment modality for small renal masses. While retroperitoneal RAPN (rRAPN) has the benefit of avoiding the peritoneal cavity and provides more direct access to the renal hilum and posterior kidney, there is concern about the feasibility of rRAPN particularly in morbidly obese [body mass index (BMI) >= 40 kg/m(2)] patients. We present a large scale multi-institutional study on the outcomes of rRAPN in morbidly obese patients. Methods: A retrospective review of a cohort of morbidly obese patients who underwent rRAPN at two academic institutions was performed. Patient characteristics, operative data, and postoperative complication rates were assessed. Results: A total of 22 morbidly obese patients were included for analysis, with a median follow-up duration of 52 months. Median patient age was 61 years and median BMI was 44.9 kg/m(2). Based on nephrometry score, 55% of the masses had low complexity and 32% had intermediate complexity. Median operative time was 186.0 minutes and median warm ischemia time was 23.5 minutes. Median postoperative length of stay was 2 days, and only one patient experienced a high-grade complication within 30 days of surgery. Conclusions: rRAPN in select morbidly obese patients appears to have acceptable operative and postoperative outcomes. Further studies and follow-up are needed to better generalization and understand long-term impacts.
Andrology Endocrinology & Metabolism Life Sciences & Biomedicine Science & Technology Urology & Nephrology

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