ANATOMY OF THE RETROPERITONEAL SPACE: IMPLICATIONS FOR SURGICAL ACCESS TO THE KIDNEY AND UPPER URINARY TRACT

Background: Surgical management of upper urinary tract pathologies requires precise knowledge of retroperitoneal anatomy. This study evaluated the impact of different surgical approaches on perioperative complications and clinical outcomes.
Methods: A retrospective single-center study was conducted on 84 adult patients who underwent upper urinary tract surgery in 2023 at Hassan II University Hospital, Fez.
Results: Open surgery was the predominant approach (97.6%, n=82), favoring the lateral retroperitoneal lumbotomy route (75.6%) over the transperitoneal route (24.4%). Minimally invasive laparoscopy represented 2.4% of cases (n=2). The overall mean length of hospital stay was 5.7 days. Complications occurred exclusively within the open surgery cohort—intraoperative (5.9%) and postoperative (7.1%)—primarily during operations for oncological pathologies and complex inflammatory stone disease.
Conclusion: Mastery of retroperitoneal anatomy remains crucial for safe open surgery. Expanding the adoption of laparoscopic and minimally invasive techniques is essential to minimize perioperative morbidity while maintaining optimal oncological and functional outcomes.