PMID- 29020831 OWN - NLM STAT- MEDLINE DCOM- 20180703 LR - 20221207 IS - 1557-900X (Electronic) IS - 0892-7790 (Linking) VI - 31 IP - 12 DP - 2017 Dec TI - Evaluation of the Role of Laparoendoscopic Single-Site Surgery vs Minilaparoscopy for Treatment of Upper Urinary Tract Pathologies: Prospective Randomized Comparative Study. PG - 1237-1242 LID - 10.1089/end.2017.0363 [doi] AB - OBJECTIVES: To present the first prospective randomized comparison between laparoendoscopic single-site surgery (LESS) and minilaparoscopy (ML) for treatment of upper urinary tract pathologies. PATIENTS AND METHODS: Between January 2013 and June 2015, patients with different upper urinary pathologies were blindly randomized to both LESS and ML. All procedures were done by single experienced surgeon. Both cohorts were compared regarding demographic data, peri and postoperative characteristics, and visual analog pain scale (VAS). Cosmetic outcome was assessed after 12 months using patient scar assessment scale (PSAS) and observer scar assessment scale (OSAS). RESULTS: Sixty patients were randomized into two equal groups with comparable demographic and preoperative characteristics. Indications included nephrectomy, pyeloplasty, cyst marsupialization, adrenalectomy, and repair of retrocaval ureter. Operative time was 167 +/- 24 and 145 +/- 39 minutes in LESS and ML groups, respectively (p = 0.09). Estimated blood loss was 59 +/- 34 and 43 +/- 42 mL in both groups, respectively (p = 0.2). VAS was 1.7 +/- 0.6 and 2.8 +/- 0.5 in both groups, respectively (p = 0.02). PSAS and OSAS were 5.9 +/- 0.85 and 10.6 +/- 1.98 vs 8.9 +/- 0.9 and 13.5 +/- 6.3 in both groups, respectively (p > 0.05). There were no intraoperative complications, conversions to open surgery, or conventional laparoscopy in both groups. Mean postoperative Diclofenac Na was 151.7 +/- 35.6 and 169.7 +/- 47.3 mg in both groups, respectively (p = 0.04). Postoperative complications rate and hospital stay were comparable between both groups. CONCLUSION: Both LESS and ML have comparable operative time, blood loss, complication rate, and hospital stay in treatment of upper urinary tract pathologies. However, LESS is associated with less analgesic requirement and better cosmetic outcome. FAU - Abdel-Karim, Aly M AU - Abdel-Karim AM AD - Urology Department, Faculty of Medicine, Alexandria University , Alexandria, Egypt . FAU - El Tayeb, Marawan M AU - El Tayeb MM AD - Urology Department, Faculty of Medicine, Alexandria University , Alexandria, Egypt . FAU - Yahia, Elsaid AU - Yahia E AD - Urology Department, Faculty of Medicine, Alexandria University , Alexandria, Egypt . FAU - Elmissiry, Mostafa AU - Elmissiry M AD - Urology Department, Faculty of Medicine, Alexandria University , Alexandria, Egypt . FAU - Hassouna, Mohamed AU - Hassouna M AD - Urology Department, Faculty of Medicine, Alexandria University , Alexandria, Egypt . FAU - Elsalmy, Salah AU - Elsalmy S AD - Urology Department, Faculty of Medicine, Alexandria University , Alexandria, Egypt . LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Endourol JT - Journal of endourology JID - 8807503 SB - IM CIN - J Endourol. 2017 Dec;31(12):1243. PMID: 29096542 MH - Adolescent MH - Adrenal Gland Diseases/*surgery MH - Adrenalectomy/adverse effects/methods MH - Adult MH - Aged MH - Cicatrix/etiology MH - Conversion to Open Surgery/*statistics & numerical data MH - Female MH - Humans MH - Intraoperative Complications/*epidemiology MH - Kidney Diseases/*surgery MH - Laparoscopy/adverse effects/*methods MH - Length of Stay MH - Male MH - Middle Aged MH - Nephrectomy/adverse effects/methods MH - Operative Time MH - Postoperative Complications/*epidemiology MH - Prospective Studies MH - Plastic Surgery Procedures/adverse effects/methods MH - Urologic Surgical Procedures/adverse effects/*methods MH - Young Adult OTO - NOTNLM OT - *LESS OT - *laparoendoscopic single-site surgery OT - *minilaparoscopy OT - *pathology OT - *upper urinary tract EDAT- 2017/10/13 06:00 MHDA- 2018/07/04 06:00 CRDT- 2017/10/13 06:00 PHST- 2017/10/13 06:00 [pubmed] PHST- 2018/07/04 06:00 [medline] PHST- 2017/10/13 06:00 [entrez] AID - 10.1089/end.2017.0363 [doi] PST - ppublish SO - J Endourol. 2017 Dec;31(12):1237-1242. doi: 10.1089/end.2017.0363.