AB075. The application of internal suspension technique in retroperitoneal laparoscopic partial nephrectomy for renal ventral tumors

BACKGROUND: To evaluate the feasibility of our novel technique using natural suspension technique in retroperitoneal laparoscopic partial nephrectomy for the management of renal ventral tumors. METHODS: Between January 2013 and July 2016, a total of 145 patients underwent retroperitoneal laparoscopic partial nephrectomy with or without our natural suspension technique. For patients underwent natural suspension technique, surgeons preserved the external fat of the renal tumor as suspension traction measure when separating the kidney. The technique provided traction on the tumor that would stabilize the tumor and maintain the tension during tumor resection. Propensity-score matching was performed according to age, gender, tumor size, tumor location and R.E.N.A.L. nephrometry score, which resulted in 32 patients with natural suspension technique matched to 32 without the technique. Patient characteristics, intraoperative and postoperative outcomes were compared between the groups. RESULTS: Baseline characteristics including age, gender, tumor size, preoperative eGFR, ASA score and R.E.N.A.L score were statistically similar for the cohorts. The use of our new technique resulted in shorter WIT (15.0 vs. 19.0 minutes; P=0.002) and tumor resection time (4.0 vs. 7.5 minutes; P<0.001). The Trifecta outcomes were significantly improved (87.5% vs. 62.5%, P=0.021) with our technique. No statistic differences were observed in the operation time, estimated blood loss, margin status and overall surgical complications between the two groups. CONCLUSIONS: This novel technique is a feasible and safe procedure in retroperitoneal laparoscopic partial nephrectomy for the management of renal ventral tumors. Prospective, larger studies are warranted for further evaluation.