Abstract :
Objectives : To evaluate retroperitoneal robot-assisted partial nephrectomy (RAPN) against transperitoneal approach in a multi-institutional prospective database, after accounting for potential selection bias that may affect this comparison. Patients and Methods : Post-hoc analysis of the prospective arm of the Vattikuti Collective Quality Initiative database from 2014-2018. Six hundred and ninety consecutive patients underwent RAPN by 22 surgeons at 14 centers in nine countries. Patients who had surgery at centers not performing retroperitoneal approach (n=197) were excluded. Inverse probability of treatment weighting was done to account for potential selection bias by adjusting for age, gender, body mass index, comorbidities, side of surgery, location/size/complexity of tumor, renal function, American Society of Anesthesiologists score, and year of surgery. Operative and perioperative outcomes were compared between weighted transperitoneal and retroperitoneal cohorts.