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Laparoendoscopic single-site pyeloplasty: a comparison with the standard laparoscopic technique.

Authors :
Stein, Robert J.
Berger, Andre K.
Brandina, Ricardo
Patel, Neil S.
Canes, David
Irwin, Brian H.
Aron, Monish
Autorino, Riccardo
Shah, Gaurang
Desai, Mihir M.
Source :
BJU International. Mar2011, Vol. 107 Issue 5, p811-815. 5p. 3 Charts.
Publication Year :
2011

Abstract

OBJECTIVE • To compare laparoendoscopic single-site (LESS) and standard laparoscopic pyeloplasty procedures with the aim of defining whether perioperative, recovery or health-related quality of life (HRQL) benefits exist for the LESS procedure. PATIENTS AND METHODS • From November 2007 to August 2008, sixteen patients underwent LESS pyeloplasty at a tertiary care referral centre. These patients were compared with a matched cohort of patients undergoing standard laparoscopic pyeloplasty. • Matching criteria included gender and age (within 10 years), as well as preoperative degree of obstruction ( T1/2 within 15 min) and differential renal function (within 10% ipsilaterally) based on diuretic radionuclide scanning. Mean follow-up was 13 ± 4 months for the LESS group and 17 ± 3 months for the standard laparoscopic group. • LESS pyeloplasty procedures were all performed using a single-port device in the umbilicus and suturing was assisted with a 2-mm grasping instrument. Perioperative variables, successful relief of obstruction and HRQL measurements were compared between the two groups. RESULTS • Except for a lower body mass index in the LESS group (23 ± 6 kg/m2 vs 30 ± 7 kg/m2, P = 0.002), no difference was noted for perioperative variables between the two cohorts, including hospital stay and analgesic requirement. • No significant HRQL advantage was noted for either group based on a six-item nonvalidated questionnaire. • All patients in both groups experienced clinical resolution of their symptoms. A patient in the standard laparoscopy group and two patients in the LESS group had T1/2 > 20 min (0.063% vs 0.125%, P = 1.00) on diuretic radionuclide scanning. • Limitations include the retrospective nature of the present study, as well as the relatively small study population and short follow-up. CONCLUSIONS • No benefit was noted for LESS pyeloplasty over the standard laparoscopic procedure beyond aesthetic advantages. • Further comparisons are needed to determine whether these results are generalizable to other LESS procedures. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14644096
Volume :
107
Issue :
5
Database :
Academic Search Index
Journal :
BJU International
Publication Type :
Academic Journal
Accession number :
58702420
Full Text :
https://doi.org/10.1111/j.1464-410X.2010.09558.x