Laparoscopic Resection in the Management of Non-adrenal and Non-renal Retroperitoneal Tumors: A Systematic Review.

Abstract

Retroperitoneal tumors (RPTs) are rare, often presenting late due to their deep anatomical location. Complete surgical excision remains the mainstay of treatment. While open surgery is traditional, advances in minimally invasive techniques have expanded laparoscopic resection to selected non-adrenal, non-renal RPTs. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we systematically searched PubMed, ScienceDirect, Google Scholar, and Cochrane Library databases up to August 1, 2025. Eligible studies included adults undergoing laparoscopic resection for large-volume, non-adrenal, non-renal RPTs, reporting perioperative outcomes. Data extraction and ROBINS-I (Risk Of Bias In Non-randomised Studies - of Interventions) quality assessment were performed. Due to heterogeneity, results were synthesized narratively without meta-analysis. Across all included studies, laparoscopic RPT resection demonstrated favorable perioperative outcomes, with a few studies directly comparing it to open surgery and reporting superior perioperative results. Operative time varied, with some reports showing longer durations laparoscopically, though learning curves reduced times substantially. Blood loss was consistently lower in the laparoscopic group, often eliminating the need for transfusions. Complication rates were low, and conversion to open surgery was infrequent. Hospital stays were shorter with earlier ambulation and diet resumption in laparoscopic cases. Feasibility was highest in early-stage and benign tumors, with high completion rates. Oncologic outcomes were comparable, with low recurrence rates in well-selected patients. These findings support the safety, efficacy, and minimally invasive advantages of laparoscopic management for RPTs in appropriately selected cases. Laparoscopic RPT resection offers reduced morbidity, faster recovery, and comparable oncologic outcomes compared to open surgery, making it a safe and effective option in selected patients and experienced surgical settings.