Laparoendoscopic single-site surgery in urology: worldwide multi-institutional analysis of 1076 cases
Autor: | Fernando J. Kim, J. Y. Lee, Jeffrey A. Cadeddu, Paolo Fornara, Wesley M. White, Anibal Branco, S. Best, E. Liatsikos, C. Giedelman, R. Sotelo, S. Yinghao, Mohamad E. Allaf, Koon Ho Rha, F. Greco, D. H. Han, A. Rane, Robert J. Stein, Ithaar Derweesh, George-Pascal Haber, Riccardo Autorino, Lee Richstone, Seung Wook Lee, Sean P. Stroup, Michael A. White, W. Linhui, Soroush Rais-Bahrami, B. C. Jeong, R. J. LeeX, Jihad H. Kaouk, Phillip M. Pierorazio, Wilson R. Molina, L. Schips, Woong Kyu Han, J. U. Stolzenburg, Luca Cindolo |
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Přispěvatelé: | Kaouk, Jh, Autorino, Riccardo, Kim, Fj, Han, Dh, Lee, Sw, Yinghao, S, Cadeddu, Ja, Derweesh, Ih, Richstone, L, Cindolo, L, Branco, A, Greco, F, Allaf, M, Sotelo, R, Liatsikos, E, Stolzenburg, Ju, Rane, A, White, Wm, Han, Wk, Haber, Gp, White, Ma, Molina, Wr, Jeong, Bc, Lee, Jy, Linhui, W, Best, S, Stroup, Sp, Rais Bahrami, S, Schips, L, Fornara, P, Pierorazio, P, Giedelman, C, Lee, Jw, Stein, Rj, Rha, Kh |
Jazyk: | angličtina |
Rok vydání: | 2011 |
Předmět: |
Adult
Male medicine.medical_specialty Urologic Neoplasms Intraoperative Complication Asia Time Factors medicine.medical_treatment Urology Single-port laparoscopy lcsh:RC870-923 Risk Assessment Port (medical) Postoperative Complications Risk Factors medicine Institutional analysis Humans Robotic surgery Laparoscopy Aged Retrospective Studies medicine.diagnostic_test business.industry Patient Selection Retrospective cohort study Perioperative Middle Aged South America lcsh:Diseases of the genitourinary system. Urology United States Surgery Europe Treatment Outcome Single site surgery Urologic Surgical Procedures Female Risk assessment business |
Zdroj: | International Brazilian Journal of Urology, Vol 37, Iss 5, Pp 662-662 (2011) International braz j urol v.37 n.5 2011 International Braz J Urol Sociedade Brasileira de Urologia (SBU) instacron:SBU International braz j urol, Volume: 37, Issue: 5, Pages: 662-662, Published: OCT 2011 |
ISSN: | 1677-6119 1677-5538 |
Popis: | Background Laparoendoscopic single-site surgery (LESS) has gained popularity in urology over the last few years. Objective To report a large multi-institutional worldwide series of LESS in urology. Design, setting, and participants Consecutive cases of LESS done between August 2007 and November 2010 at 18 participating institutions were included in this retrospective analysis. Intervention Each group performed a variety of LESS procedures according to its own protocols, entry criteria, and techniques. Measurements Demographic data, main perioperative outcome parameters, and information related to the surgical technique were gathered and analyzed. Conversions to reduced-port laparoscopy, conventional laparoscopy, or open surgery were evaluated, as were intraoperative and postoperative complications . Results and limitations Overall, 1076 patients were included in the analysis. The most common procedures were extirpative or ablative operations in the upper urinary tract. The da Vinci robot was used to operate on 143 patients (13%). A single-port technique was most commonly used and the umbilicus represented the most common access site. Overall, operative time was 160±93min and estimated blood loss was 148±234ml. Skin incision length at closure was 3.5±1.5cm. Mean hospital stay was 3.6±2.7 d with a visual analog pain score at discharge of 1.5±1.4. An additional port was used in 23% of cases. The overall conversion rate was 20.8%; 15.8% of patients were converted to reduced-port laparoscopy, 4% to conventional laparoscopy/robotic surgery, and 1% to open surgery. The intraoperative complication rate was 3.3%. Postoperative complications, mostly low grade, were encountered in 9.5% of cases. Conclusions This study provides a global view of the evolution of LESS in the field of minimally invasive urologic surgery. A broad range of procedures have been effectively performed, primarily in the academic setting, within diverse health care systems around the world. Since LESS is performed by experienced laparoscopic surgeons, the risk of complications remains low when stringent patient-selection criteria are applied. |
Databáze: | OpenAIRE |
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