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

Sey Kiat Lim, Tae Young Shin, Kwang Hyun Kim, WoongKyu Han, Byungha Chung, Sung Joon Hong, Youngdeuk Choi, KoonHo Rha

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6 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)90-97
Number of pages8
JournalBJU International
Volume114
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1

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Urinary Tract
Carcinoma
Recurrence
Survival
Blood Transfusion
Patient Selection
Neoplasms
Urinary Bladder
Hospitalization
Survival Rate
Demography
Databases
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

@article{be850e45884648d2bf0374dab5906050,
title = "Laparoendoscopic single-site (LESS) robot-assisted nephroureterectomy: Comparison with conventional multiport technique in the management of 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.",
author = "Lim, {Sey Kiat} and Shin, {Tae Young} and Kim, {Kwang Hyun} and WoongKyu Han and Byungha Chung and Hong, {Sung Joon} and Youngdeuk Choi and KoonHo Rha",
year = "2014",
month = "1",
day = "1",
doi = "10.1111/bju.12356",
language = "English",
volume = "114",
pages = "90--97",
journal = "BJU International",
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TY - JOUR

T1 - Laparoendoscopic single-site (LESS) robot-assisted nephroureterectomy

T2 - Comparison with conventional multiport technique in the management of upper urinary tract urothelial carcinoma

AU - Lim, Sey Kiat

AU - Shin, Tae Young

AU - Kim, Kwang Hyun

AU - Han, WoongKyu

AU - Chung, Byungha

AU - Hong, Sung Joon

AU - Choi, Youngdeuk

AU - Rha, KoonHo

PY - 2014/1/1

Y1 - 2014/1/1

N2 - 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.

AB - 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.

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U2 - 10.1111/bju.12356

DO - 10.1111/bju.12356

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JO - BJU International

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