دورية أكاديمية
Laparoendoscopic single-site pyeloplasty: outcomes of an international multi-institutional study of 140 patients.
| العنوان: | Laparoendoscopic single-site pyeloplasty: outcomes of an international multi-institutional study of 140 patients. |
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| المؤلفون: | Rais-Bahrami S; The Arthur Smith Institute for Urology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY, USA. soroushraisbahrami@gmail.com, Rizkala ER, Cadeddu JA, Tugcu V, Derweesh IH, Abdel-Karim AM, Kawauchi A, George AK, Autorino R, Bagrodia A, Sonmezay E, Elsalmy S, Liss MA, Harrow BM, Kaouk JH, Richstone L, Stein RJ |
| المصدر: | Urology [Urology] 2013 Aug; Vol. 82 (2), pp. 366-72. Date of Electronic Publication: 2013 Jun 28. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Science Country of Publication: United States NLM ID: 0366151 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-9995 (Electronic) Linking ISSN: 00904295 NLM ISO Abbreviation: Urology Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York : Elsevier Science Original Publication: Ridgewood, N.J., Professional Medical Services Co. |
| مواضيع طبية MeSH: | Laparoscopy*/adverse effects, Kidney Pelvis/*surgery , Ureter/*surgery , Ureteral Obstruction/*surgery, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Operative Time ; Retrospective Studies ; Young Adult |
| مستخلص: | Objective: To report an international, multi-institutional series of laparoendoscopic single-site pyeloplasty (LESS-P) with analysis of functional outcomes. Materials and Methods: LESS-P cases performed between October 2007 and June 2012 at 7 institutions worldwide per individual institutional protocols, entry criteria, and techniques were included. Patient characteristics, operative indications, perioperative outcomes, and postoperative follow-up were retrospectively collected and analyzed. Results: The study included 140 adult patients (age 39.9 ± 15.7 years; body mass index 24.8 ± 4.2 kg/m(2); 15% with previous abdominal surgery) who underwent unilateral LESS-P, most of whom (94.3%) had dismembered reconstructions. Mean operative time was 202.1 ± 47 minutes with an estimated blood loss of 61.2 ± 44.6 mL. Robotic laparoendoscopic single-site surgery was applied in 31 patients (22.1%). A single 2-3 mm accessory port was used in 44 patients (31.4%) and a single 5-12 mm accessory port was added in 9 patients (6.4%), whereas 10 patients (7.1%) were converted to conventional multiport laparoscopy. No patients required conversion to open surgery, nor were any intraoperative complications reported. Length of hospitalization was 2.4 ± 1.6 days. The overall 90-day postoperative complication rate was 18.6%, mostly low-grade complications (Clavien I-II). With a mean follow-up of 14.0 ± 10.8 months, 93.4% had resolution of symptoms and 94.4% had radiographic evidence demonstrating resolution of ureteropelvic junction obstruction. Assessment of drainage with diuretic nuclear renal scan provided evidence of improvement in 86.5% of patients on their first postoperative renal scan. Conclusion: This study highlights the most comprehensive experience with LESS-P reported to date. Outcome measures parallel those of large published series of conventional laparoscopic pyeloplasty. Despite these encouraging findings, longer follow-up is needed to determine the efficacy and durability of this approach for the treatment of ureteropelvic junction obstruction. (Copyright © 2013 Elsevier Inc. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20130702 Date Completed: 20131106 Latest Revision: 20130730 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.urology.2013.04.047 |
| PMID: | 23810729 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1527-9995 |
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| DOI: | 10.1016/j.urology.2013.04.047 |