Mini-invasive robotic assisted pyelolithotomy: Comparison between the transperitoneal and retroperitoneal approach

  • Daniele D'Agostino | dott.dagostino@gmail.com Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy.
  • Paolo Corsi Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy.
  • Marco Giampaoli Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy.
  • Federico Mineo Bianchi Department of Urology, University of Bologna, Italy.
  • Daniele Romagnoli Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy.
  • Simone Crivellaro Division of Urology, Department of Surgery, University of Illinois at Chicago, IL, United States.
  • Giacomo Saraceni Department of Urology, University of Bologna, Italy.
  • Marco Garofalo Department of Urology, University of Bologna, Italy.
  • Riccardo Schiavina Department of Urology, University of Bologna, Italy.
  • Eugenio Brunocilla Department of Urology, University of Bologna, Italy.
  • Walter Artibani Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy.
  • Angelo Porreca Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy.

Abstract

Objective: To compare the retroperitoneal with the transperitoneal approach in a series of patients underwent to robotic-assisted pyelolithotomy (RP).
Materials and methods: From January 2015 to December 2018 we evaluated 20 patients subjected to robotic pyelolithotomy; 11 patients were treated with retroperitoneal approach (RRP) and 9 with transperitoneal approach (TRP). For each patient intra and perioperative data were recorded: operative time (OT), blood loss (BL), length of hospital stay (LOS), stone clearance, post-operative complications and time to remove the drain. The presence of stone fragments < 4 mm was considered as stone free rate.
Results: The principal stone burden was greater in the TRP group than in the RRP group (48 ± 10 mm vs 32 ± 14 mm, p = 0.12). Preoperative hydronephrosis was present in 7 (64%) patients in RRP group and a mild hydronephrosis in 3 of TRP group (p = 0.04). The average operative time was higher in the RRP group than in the TRP group (203 ± 45 min vs 137 ± 31 min, p = 0.002). The average blood loss was 305 ± 175 ml in the RRP group versus 94 ± 104 ml in the TRP group (p = 0.005). The stone free rate was similar between the two groups, 36% (4 patients) in the RRP group and 44% (4 patients) in the TRP (p = 0.966).
Conclusions: RP appears to be a safe and effective minimally invasive treatment for some patients with renal staghorn calculi or urinary tract malformations. The TRP may give lower operative time and better results in terms of blood loss and length of hospital stay.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.
Published
2019-07-02
Info
Issue
Section
Original Papers - Stones and Infections
Keywords:
Transperitoneal pyelolithotomy, Retroperitoneal pyelolithotomy
Statistics
  • Abstract views: 675

  • PDF: 322
How to Cite
D’Agostino, D., Corsi, P., Giampaoli, M., Mineo Bianchi, F., Romagnoli, D., Crivellaro, S., Saraceni, G., Garofalo, M., Schiavina, R., Brunocilla, E., Artibani, W., & Porreca, A. (2019). Mini-invasive robotic assisted pyelolithotomy: Comparison between the transperitoneal and retroperitoneal approach. Archivio Italiano Di Urologia E Andrologia, 91(2). https://doi.org/10.4081/aiua.2019.2.107

Most read articles by the same author(s)