OBJECTIVE: To compare the peri-operative, pathological and oncological outcomes between Laparoendoscopic Single-Site robot-asssisted nephroureterectomy (LESS-RALNU) and Multiport robot-asssisted nephroureterectomy (M-RALNU).
MATERIALS AND METHODS: 38 patients from a tertiary institution with upper urinary tract urothelial carcinoma (UUT-UC) underwent LESS-RALNU (N=17) or M-RALNU (N=21) by a single surgeon. Data was obtained from a prospectively maintained database.
RESULTS: Patients' demographics and tumour characteristics were similar between the M-RALNU and LESS-RALNU groups. Mean follow-up was 48.4 and 30.9 months for M-RALNU and LESS-RALNU (p=0.000), respectively. Mean operative time, mean estimated blood loss and mean length of hospitalization for M-RALNU and LESS-RALNU were 251mins, 192ml, 6.5days and 247mins, 376ml and 5.4days, respectively (p>0.05). Overall, there were no significant differences in complication rates although 3 patients in the LESS-RALNU compared to none in the M-RALNU group required blood transfusion (p=0.081). The proportion of patients with bladder recurrence, local recurrence and distant metastases were similar between the two groups. There were no significant differences in the Recurrence free survival, Cancer-specific survival and Overall survival between the two groups.
CONCLUSIONS: To our knowledge, this represents the largest and the only comparative M-RALNU and LESS-RALNU study to date. Although the oncological and perioperative outcomes of patients who underwent LESS-RALNU compared well with M-RALNU and series of other surgical approaches, it might result in greater intra-operative blood losses. We suggest careful selection of patient for this technique.
Written by:
Lim SK, Shin TY, Kim KH, Han WK, Chung BH, Hong SJ, Choi YD, Rha KH. Are you the author?
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
Reference: BJU Int. 2013 Jul 8. Epub ahead of print.
doi: 10.1111/bju.12356
PubMed Abstract
PMID: 24053174
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