The 2014 guideline has been up date d by a multidisciplinary panel using the highest method ological st and ards , and provides the best and most reliable contemporary evidence base for RCC management .
CONTEXT The European Association of Urology Guideline Panel for Renal Cell Carcinoma ( RCC ) has prepared evidence -based guidelines and recommendations for RCC management .
OBJECTIVES To provide an up date of the 2010 RCC guideline based on a st and ardised methodology that is robust , transparent , reproducible , and reliable .
Prospective randomized comparison of transperitoneal versus retroperitoneal laparoscopic radical nephrectomy.
PURPOSE We report on a prospect i ve r and omized comparison of transperitoneal versus retroperitoneal laparoscopic radical nephrectomy for renal tumor . MATERIAL S AND METHODS Between June 1999 and June 2001 , 102 consecutive eligible patients with a computerized tomography identified renal tumor were prospect ively r and omized to undergo either a transperitoneal ( group 1 , 50 patients ) or retroperitoneal ( group 2 , 52 patients ) laparoscopic radical nephrectomy with intact specimen extraction . Exclusion criteria for the study included body mass index greater than 35 or a history of prior major abdominal surgery in the quadrant of interest . Both groups were matched regarding age ( 63 versus 65 years , p = 0.69 ) , BMI ( 29 versus 28 , p = 0.89 ) , American Society of Anesthesiologists class ( 2.7 versus 2.8 , p = 0.37 ) , laterality ( right side 46 % versus 48 % , p = 0.85 ) and mean tumor size ( 5.3 versus 5.0 cm , p = 0.73 ) . RESULTS All 102 procedures were technically successful without the need for open conversion . Compared to the transperitoneal approach , the retroperitoneal approach was associated with a shorter time to renal artery control ( 91 versus 34 minutes , p < 0.0001 ) , shorter time to renal vein control ( 98 versus 45 minutes , p < 0.0001 ) and shorter total operative time ( 207 versus 150 minutes , p = 0.001 ) . However , the transperitoneal and retroperitoneal approaches were similar in terms of estimated blood loss ( 180 versus 242 cc , p = 0.13 ) , hospital stay ( 43 versus 45 hours , p = 0.55 ) , intraoperative complications ( 10 % versus 7.7 % , p = 0.30 ) , postoperative complications ( 20 % versus 13.5 % , p = 0.14 ) and postoperative analgesia requirements ( 27 versus 26 mg MSO4 equivalent p = 0.13 ) . Pathology revealed renal cell carcinoma in 84 % and 75 % of cases , respectively , with no positive surgical margin in any case . CONCLUSIONS Laparoscopic radical nephrectomy can be performed efficiently and effectively with the transperitoneal or the retroperitoneal approach . While renal hilar control and total operative time may be quicker with retroperitoneoscopy , the approaches are similar in terms of other patient outcomes evaluated
The 2014 guideline has been up date d by a multidisciplinary panel using the highest method ological st and ards , and provides the best and most reliable contemporary evidence base for RCC management .
CONTEXT The European Association of Urology Guideline Panel for Renal Cell Carcinoma ( RCC ) has prepared evidence -based guidelines and recommendations for RCC management .
OBJECTIVES To provide an up date of the 2010 RCC guideline based on a st and ardised methodology that is robust , transparent , reproducible , and reliable .