在最近发表的第一篇完成机器人辅助下的腹外肾输尿管切除术（RRNU）治疗上尿路上皮癌（UTUC）的患者后，我们旨在将这种新的手术技术与代表当前常规治疗的机器人辅助腹腔镜肾输尿管切除术（TRNU）进行比较。回顾性地分析了机器人辅助下的肾输尿管切除术（NUs），并根据腹腔镜和腹外侧入路两个组别进行比较。收集了患者的基线数据，包括患者人口统计学数据、肿瘤特征、术中（EAUiaiC）和术后（Clavien-Dindo）并发症以及围手术期变量。肿瘤特征包括恶性程度、临床分期和手术切缘状态。收集了30天再入院率等短期随访数据。采用p值 < 0.05作为显著差异的统计分析方法。分析包括24例TRNU和12例RRNU治疗证实UTUC的围手术期患者数据（平均年龄：70岁与71岁；BMI：25.9 kg/m2与26.1 kg/m2；CCI评分 ≥ 4：83%与75%；ASA评分 ≥ 3：37%对33%）。术中并发症（16.4%对0%，p = 0.35）和术后并发症（25%对12.5%，p = 0.64）未显示显著差异。值得注意的是，RRNU的手术时间（p < 0.05）和住院时间（p < 0.05）均显著缩短。在组织病理学肿瘤特征方面没有显著差异，但通过RRNU摘除的淋巴结明显更多（11.0 ± 3.3 vs.6.4 ± 5.1，p < 0.05）。最后，短期随访结果未显示明显差异。我们报道了RRNU和TRNU之间的首次直接比较。 RRNU证明是一种安全、可行的方法，似乎不劣于TRNU。 RRNU扩展了最小侵袭性治疗选择的范围，特别适用于有过重大腹部手术的患者。©2023。外科肿瘤学会。

After recent presentation of the first complete robot-assisted retroperitoneal nephroureterectomy with bladder cuff (RRNU) for patients with upper tract urothelial cancer (UTUC), we aimed to compare this new surgical technique with robot-assisted transperitoneal nephroureterectomy (TRNU) representing the current standard of care.Robot-assisted nephroureterectomies (NUs) were retrospectively analyzed and compared based on two groups: transperitoneal versus retroperitoneal approach. Baseline data were collected for patient demographics, tumor characteristics, intra- (EAUiaiC) and postoperative (Clavien-Dindo) complications, and perioperative variables. Tumor characteristics included grade of malignancy, clinical stage, and surgical margin status. Short-term follow-up data including 30-day readmission rates were collected. Statistical analyses were performed assuming a significant p-value of < 0.05.The analysis includes perioperative patient data after proven UTUC of 24 TRNU versus 12 RRNU (mean age: 70 versus 71 years; BMI: 25.9 versus 26.1 kg/m2; CCI score ≥ 4: 83% versus 75%; ASA score ≥ 3: 37% vs 33%). Intraoperative (16.4% vs 0%, p = 0.35) and postoperative (25% vs 12.5%, p = 0.64) complications demonstrated no significant discrepancy. Notably, RRNU demonstrated significantly shorter surgery time (p < 0.05) and length of stay (p < 0.05). There was no significant difference in histopathological tumor characteristics, whereas significantly more lymph nodes were removed through RRNU (11.0±3.3 vs. 6.4±5.1, p < 0.05). Finally, no statistical difference was shown in short-term follow-up.We report the first head-to-head comparison between RRNU and TRNU. RRNU proves to be a safe and feasible approach which appears to be non-inferior to TRNU. RRNU expands the spectrum of minimally invasive treatment options, particularly for patients with major previous abdominal surgery.© 2023. Society of Surgical Oncology.