-Original-

Factors Associated with Prolonged Retroperitoneal Laparoscopic Radical Nephrectomy Performed by Non-expert Surgeons

Masato Yanagi¹, Go Kimura¹, Tetsuro Sekine², Hayato Takeda¹, Jun Akatsuka¹, Yuki Endo¹, Tatsuro Hayashi¹, Tsutomu Hamasaki³ and Yukihiro Kondo¹

¹Department of Urology, Nippon Medical School Hospital, Tokyo, Japan
²Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan
³Department of Urology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan

Background: High body mass index (BMI) and visceral obesity were reported to be associated with prolonged transperitoneal laparoscopic radical nephrectomy (LRN); however, factors that prolong retroperitoneal LRN remain unknown. We therefore investigated factors associated with prolonged retroperitoneal LRN performed by non-expert surgeons.
Methods: We defined non-experts surgeons as surgeons not certified to perform laparoscopic surgery by the Japanese Society of Endourology. We retrospectively reviewed the medical records of 59 consecutive patients with renal cell carcinoma treated with retroperitoneal LRN performed by non-experts at our hospital between 2014 and 2019. Associations of surgical duration with age, sex, BMI, visceral fat area (VFA), subcutaneous fat area (SFA), laterality and location of the tumor, length of the major tumor axis (tumor length), clinical T stage, ipsilateral adrenalectomy and specimen weight were analyzed using Spearman rank correlation coefficients.
Results: Surgical duration positively correlated with ipsilateral adrenalectomy (rs = 0.3162, p = 0.0147) and specimen weight (rs = 0.3103, p = 0.0168) but not with BMI (rs = 0.2016, p = 0.1257) or VFA (rs = 0.0185, p = 0.8894).
Conclusions: Ipsilateral adrenalectomy and specimen weight were associated with prolonged retroperitoneal LRN, when performed by non-expert surgeons.

J Nippon Med Sch 2021; 88: 109-112

Keywords
laparoscopic radical nephrectomy, retroperitoneal approach, non-expert

Correspondence to
Masato Yanagi, Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
area-i@nms.ac.jp

Received, January 31, 2020
Accepted, April 20, 2020