Laparoscopic Management of Retroperitoneal Masses: Our Experience and Literature Review

Background: Retroperitoneal growths often require surgical exploration for diagnostic and/or therapeutic purposes. Here in, we present our experience in laparoscopic management of retroperitoneal masses and review the literature to assess the feasibility of a minimally invasive approach in this setting. Method: In the last 4 years 8 consecutive patients, aged 46 to 73 years, underwent laparoscopic surgery for isolated retroperitoneal masses at our institution. Medical records were reviewed collecting data regarding clinical presentation, dimensions of the finding, pathology, whether a preoperative biopsy was performed and its results, procedure performed (excision versus incisional biopsy), operative times, estimated blood loss, complications, hospital stay and follow-up. Results: All procedures were successfully completed laparoscopically with no conversions. Mean operative time was 131 minutes. Blood loss was 0-200 mL and blood transfusions were not required. One bowel injury was repaired intraoperatively; postoperative course was uneventful in all cases. Hospital stay ranged from 2 to 7 days. Final pathology was local recurrence of Renal cell carcinoma in 3 cases, 1 lymphoma, 1 sarcoma, 1 schwannoma and 2 retroperitoneal cysts. With an average followup of over 2 years there are no recurrences. Conclusions: Laparoscopic approach is a feasible approach in selected patients with retroperitoneal masses. In our experience, laparoscopy offers a viable and oncologically radical option with excellent results and low morbidity. This minimally invasive approach is likely to become more common practice as the experience grows and new technologies become available.