INTRODUCTION: In the past years, several authors have focused on the role of retroperitoneoscopic laparoscopy in the treatment of urological diseases. Aim of our study is to systematically review the available literature on retro-peritoneoscopic laparoscopy in urology. EVIDENCE ACQUISITION: A systematic review of the literature using the Medline, Scopus, and Web of Science databases for relevant articles published until June 2018 was performed using both the Medical Subjects Heading and free test protocols. The MeSH search was conducted by combining the following terms: “retroperitoneoscopy,” “posterior laparoscopy,” “retroperitoneoscopic.” Only randomized clinical trials were included in the analysis. Risk of bias assessment and forest plots were used to summarize data. EVIDENCE SYNTHESIS: Nine RCTs on simple, partial and radical nephrectomy, pyeloplasty, ureterolithotomy and nephrolithotomy comparing RP to other techniques were included in the analysis. Retroperitoneoscopic approach in simple or radical nephrectomy is to be considered a valid alternative to transperitoneal laparoscopic approach. Outcomes and safety profiles (6-8% conversion rate) are similar and the approach depends on surgeon’s preferences. Randomized studies analyzing retroperitoneoscopic pyeloplasty showed better results in terms of perioperative morbidity (tramadol use: 147 vs. 179 mg, P=0.002) and return to normal activities when compared to either anterior laparoscopic either to minimally invasive open approach. Two randomized studies have confirmed the efficacy (stone-free rate: 94%) and safety (no Clavien-Dindo >II complications) of ureterolithotomy and nephrolithotomy (stone-free rate: 95%) in the management of large renal and ureteral stones. CONCLUSIONS: Retroperitoneoscopic approach in urological diseases is a valid alternative to the anterior approach. Evidence suggest lower morbidity for the retroperitoneoscopic approach however technical complexity may limit its widespread.

Retroperitoneoscopy in urology. A systematic review / Lombardo, R.; Martos, R.; Ribal, M. J.; Alcaraz, A.; Tubaro, A.; de Nunzio, C.. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - 71:1(2019), pp. 9-16. [10.23736/S0393-2249.18.03235-6]

Retroperitoneoscopy in urology. A systematic review

Lombardo R.
;
Alcaraz A.;Tubaro A.;de Nunzio C.
2019

Abstract

INTRODUCTION: In the past years, several authors have focused on the role of retroperitoneoscopic laparoscopy in the treatment of urological diseases. Aim of our study is to systematically review the available literature on retro-peritoneoscopic laparoscopy in urology. EVIDENCE ACQUISITION: A systematic review of the literature using the Medline, Scopus, and Web of Science databases for relevant articles published until June 2018 was performed using both the Medical Subjects Heading and free test protocols. The MeSH search was conducted by combining the following terms: “retroperitoneoscopy,” “posterior laparoscopy,” “retroperitoneoscopic.” Only randomized clinical trials were included in the analysis. Risk of bias assessment and forest plots were used to summarize data. EVIDENCE SYNTHESIS: Nine RCTs on simple, partial and radical nephrectomy, pyeloplasty, ureterolithotomy and nephrolithotomy comparing RP to other techniques were included in the analysis. Retroperitoneoscopic approach in simple or radical nephrectomy is to be considered a valid alternative to transperitoneal laparoscopic approach. Outcomes and safety profiles (6-8% conversion rate) are similar and the approach depends on surgeon’s preferences. Randomized studies analyzing retroperitoneoscopic pyeloplasty showed better results in terms of perioperative morbidity (tramadol use: 147 vs. 179 mg, P=0.002) and return to normal activities when compared to either anterior laparoscopic either to minimally invasive open approach. Two randomized studies have confirmed the efficacy (stone-free rate: 94%) and safety (no Clavien-Dindo >II complications) of ureterolithotomy and nephrolithotomy (stone-free rate: 95%) in the management of large renal and ureteral stones. CONCLUSIONS: Retroperitoneoscopic approach in urological diseases is a valid alternative to the anterior approach. Evidence suggest lower morbidity for the retroperitoneoscopic approach however technical complexity may limit its widespread.
2019
laparoscopy; retroperitoneal space; systematic review
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Retroperitoneoscopy in urology. A systematic review / Lombardo, R.; Martos, R.; Ribal, M. J.; Alcaraz, A.; Tubaro, A.; de Nunzio, C.. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - 71:1(2019), pp. 9-16. [10.23736/S0393-2249.18.03235-6]
File allegati a questo prodotto
File Dimensione Formato  
Lombardo_Retroperitoneoscopy_2019.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 1.16 MB
Formato Adobe PDF
1.16 MB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1456464
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 13
  • ???jsp.display-item.citation.isi??? 8
social impact