Korean J Urol.  2013 Apr;54(4):244-248.

A Comparative Study of Laparoendoscopic Single-Site Surgery Versus Conventional Laparoscopy for Upper Urinary Tract Malignancies

• Kim J
• Yu HS
• Cho KS
• Han WK
• Ham WS

Abstract

PURPOSE
The proper indication for laparoendoscopic single-site surgery (LESS) in urology is still under debate, especially for malignant diseases. We compared the perioperative outcomes between LESS and conventional laparoscopy (CL) for upper urinary tract malignancies.
MATERIALS AND METHODS
We reviewed the records of 75 patients who underwent radical nephrectomy, nephroureterectomy with bladder cuff excision, or partial nephrectomy with the LESS or CL approach between December 2008 and December 2010. We compared characteristics and perioperative outcomes between patients who underwent LESS or CL. All operations were performed by three surgeons using the transperitoneal approach.
RESULTS
For all three surgery types, no differences in patient characteristics, estimated blood losses, transfusion rates, or durations of hospital stay were found between the two groups. No complications were found between the two groups in those who underwent nephroureterectomy with bladder cuff excision; however, significantly more complications were found in the LESS group than in the CL group in those who underwent radical nephrectomy or partial nephrectomy. Most of the complications with LESS radical nephrectomy occurred in the early introduction period of the technique.
CONCLUSIONS
No significant differences in perioperative outcomes were found between the LESS and CL groups in those who underwent radical nephrectomy or nephroureterectomy with bladder cuff excision. Therefore, the use of LESS in these cases is expected to expand as surgeons gain more experience with this technique and as other technical advances in laparoscopic instruments occur. However, partial nephrectomy with LESS should be performed restrictively considering the current level of surgical skill.

Keyword

Laparoscopy; Nephrectomy; Renal cell carcinoma; Ureteral neoplasms

MeSH Terms

Carcinoma, Renal Cell
Humans
Laparoscopy
Length of Stay
Nephrectomy
Ureteral Neoplasms
Urinary Bladder
Urinary Tract
Urology

Figure

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  FIG. 1 Gross pathologic image of laparoendoscopic single-site surgery nephroureterectomy with bladder cuff excision. Final pathologic result: high-grade transitional cell carcinoma, pT3, located at the right lower ureter with a negative bladder cuff excision margin.

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