Robotic resection of benign nonadrenal retroperitoneal tumors: A consecutive case series.

BACKGROUND: The deep location, narrow operative space and proximity to major vessels make minimally invasive resection of nonadrenal retroperitoneal tumors (NTRs) challenging and rarely reported. This study aimed to evaluate the safety and feasibility of robotic resection of benign nonadrenal retroperitoneal tumors.

METHODS: The demographics and perioperative outcomes of a consecutive series of patients who underwent robotic NTR resection between January 1, 2015, and August 30, 2017, were analyzed.

RESULTS: Twenty-five patients (9 men and 16 women; mean age, 50.5 years) were included in the study. The mean largest tumor diameter was 4.9 cm, 11 had a tumor larger than 5 cm and 13 had a tumor adherent to major vessels. The mean operative time was 139.0 min, and the median estimated blood loss was 50.0 mL (interquartile range, 30-80 mL). No patients required conversion to laparotomy or blood transfusion. Postoperative morbidities occurred in 3 patients (12%), and all recovered after conservative treatment. The mean postoperative hospital stay was 4.8 days. On histopathological examination all the tumors were benign: lymphangioma (8, 32%), schwannoma (5, 20%), lymphatic cyst (4, 16%), paraganglioma (2, 8%), bronchogenic cyst (2, 8%), mucinous cystadenoma (1, 4%), neurofibroma (1, 4%), ganglioneuroma (1, 4%), and Castleman disease (1, 4%). Neither large tumor size nor adherence to major vessels affected the perioperative outcomes.

CONCLUSIONS: Robotic resection of NRTs is safe and feasible even for tumors which were large or adherent to major vessels.