1Department of Urology, Daxing Hospital, Capital Medical University, Beijing 102600, China; 2Department of Urology, Chinese People's Liberation Army General Hospital
Abstract:Objective:To assess the clinical efficacy of retroperitoneal laparoendoscopic single-site radical nephrectomy (LESSRN) versus standard laparoscopic radical nephrectomy (SLAN). Methods:Between April 2011 and August 2012,53 patients with renal cancer in our center underwent retroperitoneal LESSRN by using a homemade single-port device, and during the same period, 53 cases undergoing SLAN were randomly analyzed. The clinical and pathological parameters of the two groups were analyzed, including gender, age, body mass index, operative time, estimated blood loss, drainage volume of the wound, wound drainage tube removal, hospital stay, operative side, tumor size, tumor location, clinical TNM stage, Fuhrman grade, and complications. Results:No significant differences were found in gender, age, body mass index, operative time, estimated blood loss, operative side, tumor size, tumor location, clinical TNM stage, Fuhrman grade, and complications between two groups (P>0.05). The time of wound drainage tube removal and hospital stay in the LESSRN group were significantly shorter than in SLAN group (P<0.05). Conclusions:Compared with SLAN, retroperitoneal LESSRN using a homemade single-port device is a safe and feasible procedure for management of localized renal cancer, and have provided a better cosmetic outcome and shorter hospital stays.
[1]Clayman RV, Kavoussi LR, Soper NJ, et al. Laparoscopic nephrectomy:Initial case report. J Urol, 1991, 146(2):278-282. [2]Ljungberg B, Cowan NC, Hanbury DC, et al. EAU guidelines on renal cell carcinoma:the 2010 update. Eur Urol, 2010, 58(3):398-406. [3]Lowry PS, Moon TD, D'Alessandro A, et al. Symptomatic port-site hernia associated with a non-bladed trocar after laparoscopic live-donor nephrectomy. J Endourol, 2003, 17(7):493-494. [4]Chueh SC, Sankari BR, Chung SD, et al. Feasibility and safety of retroperitoneoscopic laparoendoscopic single-site nephrectomy: Technique and early outcomes. BJU Int, 2011, 108(11):1879-1885. [5]Raman JD, Bensalah K, Bagrodia A, et al. Laboratory and clinical development of single keyhole umbilical nephrectomy. Urology, 2007, 70(6):1039-1042. [6]黄毅,阴雷,黄海,等.R.E.N.A.L评分在后腹腔镜下肾部分切除术中预测肾脏热缺血时间的应用.微创泌尿外科杂志,2013,2(5):324-327. [7]蔡伟,董隽,张旭,等.单孔后腹腔镜根治性肾切除手术研究.临床泌尿外科杂志, 2011, 26(10):724-725. [8]Autorino R, Cadeddu J, Desai M, 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. [9]董隽, 祖强, 孙圣坤, 等.自制单孔多通道设备行后腹腔镜活体供肾切取术(附4例报告).临床泌尿外科杂志, 2011, 26(12):881-883. [10]张国玺,伍耿青,邹晓峰.耻骨上辅助单孔腹腔镜肾切除术(附90例报告).微创泌尿外科杂志,2013,2(6):364-367. [11]Tracy CR, Raman JD, Cadeddu JA, et al. Laparoendoscopic single-site surgery in urology: where have we been and where are we heading? Nat Clin Pract Urol, 2008, 5(10):561-568.