Laparoendoscopic single-site nephrectomy and standard laparoscopic partial nephrectomy: a comparison of clinical efficacy
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Department of Urology,Changzheng Hospital,Second Military Medical University,Department of Urology,Changzheng Hospital,Second Military Medical University,Department of Urology,Changzheng Hospital,Second Military Medical University,Department of Urology,Changzheng Hospital,Second Military Medical University,Department of Urology,Changzheng Hospital,Second Military Medical University,Department of Urology,Changzheng Hospital,Second Military Medical University,Department of Urology,Changzheng Hospital,Second Military Medical University,Department of Urology,Changzheng Hospital,Second Military Medical University

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Supported by National Natural Science Foundation of China (81272817, 81172447) and Natural Science Foundation of Shanghai (11ZR1447800).

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    Abstract:

    Objective To compare the clinical outcomes of laparoendoscopic single-site (LESS) and traditional standard laparoscopy partial nephrectomy surgery, so as to investigate the characteristics, safety, feasibility, advantages and disadvantages of LESS nephrectomy surgery. Methods The same surgical group completed 12 cases of LESS partial nephrectomy from August 2009 to February 2015; 22 cases who received standard laparoendoscopic partial nephrectomy in the same period served as controls; two groups had similar tumor size and DAP scores. The clinical data were retrospectively analyzed to compare the clinical efficacies of the two groups. Results All procedures were completed successfully without conversion to open cases in the two groups. The body mass index, tumor size or DAP scores were not statistically different between the both groups (P>0.05). The bowel recovery time, pain score, and cutouts satisfaction scores of LESS group were significantly different between the two groups ([1.50±0.71] d vs[2.45±0.96] d, 3.5 ±1.2 vs 4.3±0.9, and 8.1±1.8 vs 7.2±2.1, P<0.05). The operation time, blood loss, and warm ischemia time of LESS group were not significantly different from those of the standard group ([213.1 ±33.9] min vs[208.5 ±65.7] min,[92.7 ±66.8] mL vs[162.3±168.1] mL, and[20.5±12.8] min vs[19.5±7.5] min, P>0.05). The renal glomerular filtration rate (GFR) was measured with 99mTc-DTPA before and 1 month after the operation, and the GFR of LESS and standard laparoendoscopic groups had a decrease of (3.7±8.6) mL/min and (8.9±10.1) mL/min, respectively, showing no significant difference (P>0.05). Conclusion The LESS nephrectomy is safe and effective, which has a similar outcome with standard laparoendoscopic partial nephrectomy when the tumor is small and in a good position.

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History
  • Received:March 06,2016
  • Revised:April 28,2016
  • Adopted:July 08,2016
  • Online: July 27,2016
  • Published:
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