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Laparoendoscopic single-site (LESS) robot-assisted nephroureterectomy: Comparison with conventional multiport technique in the management of upper urinary tract urothelial carcinoma

Authors
 Sey Kiat Lim  ;  Tae-Young Shin  ;  Kwang Hyun Kim  ;  Woong Kyu Han  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Young Deuk Choi  ;  Koon Ho Rha 
Citation
 BJU INTERNATIONAL, Vol.114(1) : 90-97, 2014 
Journal Title
 BJU INTERNATIONAL 
ISSN
 1464-4096 
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Female ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/methods* ; Male ; Middle Aged ; Neoplasm Recurrence, Local/etiology ; Nephrectomy/adverse effects ; Nephrectomy/methods* ; Postoperative Complications/etiology ; Risk Factors ; Robotics* ; Treatment Outcome ; Ureter/surgery* ; Ureteroscopy/adverse effects ; Ureteroscopy/methods* ; Urologic Neoplasms/surgery* ; Urologic Surgical Procedures/adverse effects ; Urologic Surgical Procedures/methods ; Urothelium/surgery
Keywords
laparoendoscopic single-site (LESS) surgery ; nephroureterectomy ; robot ; upper urinary tract urothelial carcinoma
Abstract
OBJECTIVE: To compare the peri-operative, pathological and oncological outcomes of laparoendoscopic single-site (LESS) robot-assisted nephroureterectomy (LESS-RALNU) with those of multiport robot-asssisted nephroureterectomy (M-RALNU). PATIENTS AND METHODS: A total of 38 patients with upper urinary tract urothelial carcinoma underwent LESS-RALNU (n = 17) or M-RALNU (n = 21) by a single surgeon at a tertiary institution. Data were obtained from a prospectively maintained database. RESULTS: Patients' demographics and tumour characteristics were similar between the M-RALNU and LESS-RALNU groups. The mean follow-up was 48.4 months for M-RALNU and 30.9 months for LESS-RALNU (P = 0). The mean operating time, estimated blood loss and length of hospitalization for M-RALNU and LESS-RALNU were 251 min, 192 mL, 6.5 days and 247 min, 376 mL and 5.4 days, respectively (P > 0.05). Overall, there were no significant differences in complication rates, although three patients in the LESS-RALNU group required blood transfusion, whereas no patient in the M-RALNU group did (P = 0.081). The proportion of patients with bladder recurrence, local recurrence and distant metastases was similar between the two groups. There were no significant differences in the recurrence-free survival, cancer-specific survival and overall survival rates between the two groups. CONCLUSIONS: Although the oncological and peri-operative outcomes of patients who underwent LESS-RALNU compared well with those who underwent M-RALNU and with series of other surgical approaches, LESS-RALNU might result in greater intra-operative blood loss. We suggest careful selection of patient for this technique.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/bju.12356/abstract
DOI
10.1111/bju.12356
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kwang Hyun(김광현)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Shin, Tae Young(신태영)
Lim, Sey Kiat(임세이캣)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99679
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