Retroperitoneoscopic partial nephrectomy in children: a multicentric international comparative study between lateral...

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Urologic Oncology

Background:

• Limited data exists on optimal retroperitoneoscopic surgery techniques.
• This study compares lateral versus prone approaches for retroperitoneoscopic partial nephrectomy (RPN) in pediatric patients.

Purpose of the Study:

• To compare the outcomes of lateral and prone approaches for RPN in children.
• To evaluate operative time, complications, and re-operations between the two techniques.

Main Methods:

• Retrospective review of 164 pediatric RPN cases from 7 international centers.
• Patients were divided into lateral (G1, n=61) and prone (G2, n=103) groups.
• Comparison of operative time, intraoperative and postoperative complications, and re-operations.

Main Results:

• Prone RPN (G2) had significantly shorter operative times (99 min) than lateral RPN (G1) (160 min).
• No significant differences in intraoperative or overall postoperative complications were observed.
• Symptomatic residual distal ureteric stumps (RDUS) were significantly more frequent after prone RPN (6.8% vs 1.6%).

Conclusions:

• Both lateral and prone RPN approaches are feasible and safe in children.
• The prone approach is faster, but the lateral approach may be preferable for cases requiring longer ureterectomy to prevent symptomatic RDUS.
• Surgical technique choice depends on surgeon preference and specific clinical indications.