Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy

Milan Hora; Viktor Eret; Petr Stránský; Ivan Trávníček; Tomáš Ürge; Jiří Ferda; Fredrik Petersson; Ondřej Hes

doi:10.5114/wiitm.2014.43019

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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abstract:

Original paper

Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy

Milan Hora

,

Viktor Eret

,

Petr Stránský

,

Ivan Trávníček

,

Tomáš Ürge

,

Jiří Ferda

,

Fredrik Petersson

,

Ondřej Hes

Videosurgery Miniinv 2014; 9 (3): 371–379

DOI: https://doi.org/10.5114/wiitm.2014.43019

Online publish date: 2014/05/26

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AMA

Hora M, Eret V, Stránský P, et al. Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy. Videosurgery and Other Miniinvasive Techniques. 2014;9(3):371-379. doi:10.5114/wiitm.2014.43019.

APA

Hora, M., Eret, V., Stránský, P., Trávníček, I., Ürge, T.,  & Ferda, J. et al. (2014). Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy. Videosurgery and Other Miniinvasive Techniques, 9(3), 371-379. https://doi.org/10.5114/wiitm.2014.43019

Chicago

Hora, Milan, Viktor Eret, Petr Stránský, Ivan Trávníček, Tomáš Ürge, Jiří Ferda,  and Fredrik Petersson et al. 2014. "Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy". Videosurgery and Other Miniinvasive Techniques 9 (3): 371-379. doi:10.5114/wiitm.2014.43019.

Harvard

Hora, M., Eret, V., Stránský, P., Trávníček, I., Ürge, T., Ferda, J., Petersson, F.,  and Hes, O. (2014). Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy. Videosurgery and Other Miniinvasive Techniques, 9(3), pp.371-379. https://doi.org/10.5114/wiitm.2014.43019

MLA

Hora, Milan et al. "Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy." Videosurgery and Other Miniinvasive Techniques, vol. 9, no. 3, 2014, pp. 371-379. doi:10.5114/wiitm.2014.43019.

Vancouver

Hora M, Eret V, Stránský P, Trávníček I, Ürge T, Ferda J et al. Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy. Videosurgery and Other Miniinvasive Techniques. 2014;9(3):371-379. doi:10.5114/wiitm.2014.43019.

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Introduction: One way how to reduce morbidity and improve cosmesic of kidney surgery is single site laparoscopy. Relatively well described concept but without defined position in clincal practise.

Aim: To report of institutional experience with laparoendoscopic single-site surgery (LESS) nephrectomy (NE) and compare (matched case-control study) it with that of standard laparoscopic NE (LNE).

Material and methods: In the period 8/2011 to 10/2013, we performed 183 mini-invasive NE (132 tumours, 51 benign aetiology); 45 of them (24.6%) were LESS, the rest LNE. The main but not absolute indications for LESS were: non-obese men, and less advanced tumours. In 13 patients undergoing LESS-NEs (28.9%) there was a transumbilical approach. For the rest, a pararectal incision was performed and an accessory port was added in 31.1% (14) – 2/22 (9.1%) left sided, 12/23 (52.2%) right sided. Twenty-four LESS-NE were performed by a more experienced surgeon (mean operation time (MOT) 73.1 min), 21 LESS-NE by 4 other surgeons (MOT 132.8 min). These 24 were compared with 43 LNE done by the same surgeon before the period of LESS (1/2007–8/2011) and with similar characteristics of cases (body mass index (BMI) ≤ 35 kg/m2, less advanced tumour).

Results: We found no statistically significant differences in any of the parameters studied. The MOT 73.1 min vs. 75.0 min (p = 0.78), BMI 27.4 kg/m2 vs. 29.2 kg/m2 (p = 0.08), blood loss 54.7 vs. 39.2 (p = 0.47). Complications (4.2% vs. 11.6%) were only of internal character in origin. No conversion in either group. In LESS-NE, staplers were used more frequently (more expensive than clips) for division of renal hilar vessels (70.8% vs. 51.2%). The mean price of LESS-NE was €367 higher.

Conclusions: The LESS NE performed by an experienced surgeon is a safe and efficient method for the surgical treatment of both malignant and benign renal conditions in patients with BMI < 30 kg/m2 and with low-stage tumours. The LESS NE is more expensive compared to LNE.

keywords:

Position of laparo-endoscopic single-site surgery nephrectomy in clinical practice and comparison (matched case-control study) with standard laparoscopic nephrectomy

Milan Hora , Viktor Eret , Petr Stránský , Ivan Trávníček , Tomáš Ürge , Jiří Ferda , Fredrik Petersson , Ondřej Hes

kidney tumour, nephrectomy, laparoscopy, laparoendoscopic single-site surgery

Milan Hora

,

Viktor Eret

,

Petr Stránský

,

Ivan Trávníček

,

Tomáš Ürge

,

Jiří Ferda

,

Fredrik Petersson

,

Ondřej Hes