Abstract:Objective:To verify the safety and feasibility of applying laparoendoscopic single-site surgery (LESS) in the treatment of urological tumors.Methods:From Oct 2009 to Aug 2012, we used LESS surgery technique to treat seven prostate cancer cases, four kidney tumor cases (one right, three left), one left renal pelvic cancer case, one left ureteral cancer case and 12 adrenal tumor and cyst cases. The radical prostatectomy was preformed through extra-peritoneal approach in first six cases and trans-peritoneal approach in 7th case, nephrectomy and nephreoureterectomy were performed through trans-peritoneal approach and adrenalectomy was performed through retroperitoneal approach. We evaluated this technique in respects of operative time, estimated blood loss, intraoperative complications, first post-operative day Visual Analog Pain Scale (VAPS) and post-operative hospital stay.Results:All procedures of the 25 cases in this group were completed with pure LESS without additional assistant trocar or conversion to standard laparoscopic surgery or open surgery. The average operative time for LESS radical prostatectomy, nephrectomy and nephroureterectomy, adrenalectomy were 259.3(190-305)min, 203.3 (120-255) min and 91.7(35-185)min respectively. The VAPS in the first post-operative day were 1.2 (0-3)d, 1.3 (0-2)d and 1.8(1-3)d. There was no severe intraoperative complication. There was no secondary bleeding or wound infection. All the malignant specimens in this group were negative in surgical margin.Conclusions:LESS is a safe and feasible option for the treatment of urological tumors.
朱刚, 张亚群, 张耀光, 金滨, 魏东, 万奔, 王建业. 单孔腹腔镜手术治疗泌尿系统肿瘤[J]. 微创泌尿外科杂志, 2012, 1(1): 52-55.
Zhu Gang, Zhang Yaqun, Zhang Yaoguang, Jin Bin, Wei Dong, Wan Ben, Wang Jianye. Application of laparoendoscopic single-site surgery in the treatment of urological tumors. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2012, 1(1): 52-55.
[1]Autorino R, Cadeddu JA, Desai MM, et al. Laparoendoscopic single-site and natural orifice transluminal endoscopic surgery in urology: a critical analysis of the literature. Eur Urol, 2011, 59(1):26-45. [2]朱刚,朱生才,刘明,等.经腹腔外途径腹腔镜下前列腺癌根治术.中华泌尿外科杂志,2009,30(1):51-54. [3]Wille AH, Roigas J, Deger S, et al. Laparoscopic radical nephrectomy: techniques, results and oncological outcome in 125 consecutive cases. Eur Urol, 2004, 45(4):483-488. [4]Zhang X, Fu B, Lang B, et al. Technique of anatomical retroperitoneoscopic adrenalectomy with report of 800 cases. J Urol, 2007,177(4):1254-1257. [5]Heidenreich A, Bellmunt J, Bolla M, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol, 2011, 59(1):61-71. [6]Raman JD, Cadeddu JA, Rao P, et al. Single-incision laparoscopic surgery: initial urological experience and comparison with naturalorifice transluminal endoscopic surgery. BJU Int, 2008, 101(12):1493-1496. [7]Kaouk JH, Haber GP, Goel RK, et al. Single-port laparoscopic surgery in urology: initial experience. Urology, 2008, 71(1):3-6. [8]White MA, Haber GP, Autorino R, et al. Robotic laparoendoscopic single-site radical prostatectomy: technique and early outcomes. Eur Urol, 2010, 58(4): 544-550. [9]朱刚,张亚群,张耀光,等. 单孔腹腔镜下根治性前列腺切除术的初步经验. 中华泌尿外科杂志, 2011, 32(3): 209-211. [10]Desai MM, Rao PP, Aron M, et al. Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int, 2008,101(1):83-88. [11]Tugcu V, Ilbey YO, Mutlu B, et al. Laparoendoscopic single-site surgery versus standard laparoscopic simple nephrectomy: a prospective randomized study. J Endourol, 2010,24(8):1315-1320. [12]张旭,马鑫,李宏召,等. 单孔后腹腔镜解剖性肾上腺切除术5例报告.临床泌尿外科杂志, 2009, 24(9): 647-650.