Laparoendoscopic Single-Site Surgeries: A Single-Center Experience of 171 Consecutive Cases
최경화, 함원식, 나군호, 이제원, 전황균, Arkoncel Francis Raymond P., 양승철, 한웅규,
소속 상세정보
최경화 ( Choi Kyung-Hwa )
Yonsei University College of Medicine Department of Urology
함원식 ( Ham Won-Sik )
Yonsei University College of Medicine Department of Urology
나군호 ( Rha Koon-Ho )
Yonsei University College of Medicine Department of Urology
이제원 ( Lee Jae-Won )
Yonsei University College of Medicine Department of Urology
전황균 ( Jeon Hwang-Gyun )
CHA University CHA Bundang Medical Center Department of Urology
( Arkoncel Francis Raymond P. )
Yonsei University College of Medicine Department of Urology
양승철 ( Yang Seung-Choul )
Yonsei University College of Medicine Department of Urology
한웅규 ( Han Woong-Kyu )
Yonsei University College of Medicine Department of Urology
KMID : 0358320110520010031
Abstract
Purpose: We report our experience to date with 171 patients who underwent laparoendoscopic single-site surgery for diverse urologic diseases in a single institution.
Materials and Methods: Between December 2008 and August 2010, we performed 171 consecutive laparoendoscopic single-site surgeries. These included simple nephrectomy (n=18; robotic surgeries, n=1), radical nephrectomy (n=26; robotic surgeries, n=2), partial nephrectomy (n=59; robotic surgeries, n=56), nephroureterectomy (n=20; robotic surgeries, n=12), pyeloplasty (n=4), renal cyst decortications (n=22), adrenalectomy (n=4; robotic surgeries, n=2), ureterolithotomy (n=10), partial cystectomy (n=3), ureterectomy (n=1), urachal mass excision (n=1), orchiectomy (n=1), seminal vesiculectomy (n=1), and retroperitoneal mass excision (n=1). All procedures were performed by use of a homemade single-port device with a wound retractor and surgical gloves. A prospective study was performed to evaluate outcomes in 171 cases.
Results: Of the 171 patients, 98 underwent conventional laparoendoscopic single-site surgery and 73 underwent robotic laparoendoscopic single-site surgery. Mean patient age was 53 years, mean operative time was 190.8 minutes, and mean estimated blood loss was 204 ml. Intraoperative complications occurred in seven cases (4.1%), and postoperative complications in nine cases (5.3%). There were no complications classified as Grade IIIb or higher (Clavien-Dindo classification for surgical complications). Conversion to mini-incision open surgery occurred in seven (4.1%) cases. Regarding oncologic outcomes, no cancer-related events occurred during follow-up other than one aggressive progression of Ewing sarcoma.
Conclusions: Laparoendoscopic single-site surgery is technically feasible and safe for various urologic diseases; however, surgical experience and long-term follow-up are needed to test the superiority of laparoendoscopic single-site surgery.
키워드
Kidney; Laparoscopy; Minimally invasive surgical procedures; Robotics; Ureter
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