Dr. Stifelman on retroperineal partial nephrectomy for anterior vs posterior renal tumors

In this video, Michael D. Stifelman, MD, discusses findings from his study, “A Comparative Analysis of Robot-assisted Retroperitoneoscopic Partial nephrectomy (RARPN) for Anterior vs Posterior Renal tumors: A Propensity Score Matched Analysis in a Multi-Institutional Cohort,” which was presented at the 2023 American Urological Association Annual Meeting in Chicago, Illinois. Stifelman is the chair of urology and director of robotic surgery at Hackensack University Medical Center in New Jersey.

Video Transcript:

What we wanted to look at is the use of the retroperineal approach for kidney cancer, and specifically look at the difference in when it's used for a tumor that's posteriorly located, on the back of the kidney, versus anteriorly located, on the front. Everyone we included in our study had a retroperitoneal approach, and again, we then used propensity score matching.

Number one, there was such a difference in the number of cases that were done for posterior tumors versus anterior tumors, as you would expect. Most retroperitoneal approaches are used for a posterior tumor. So, since there was such a difference, we use what's called propensity score matching. We matched it by the size of the tumor, and then a nephrometry score. That way, we could compare equal cohorts to look at if there are any differences when you do an anterior approach retroperitoneally versus a posterior tumor performed retroperitoneally.

What we found was there was no difference. Operative time was the same, blood loss of the same, positive margin rate was not statistically significant, length of stay was the same. What that suggests is that even though most urologists who do retroperitoneal surgery do it for posterior tumors, you actually can do it equally well with as equally good success for an anterior tumor.

This transcription has been edited for clarity.