Complications during the initial experience with laparoendoscopic single-site pyeloplasty

作者：Best Sara L; Donnally Chester; Mir Saad A; Tracy Chad R; Raman Jay D; Cadeddu Jeffrey A^*

来源：BJU International, 2011, 108(8): 1326-1329.

DOI：10.1111/j.1464-410X.2011.10078.x

• LESS
• laparoendoscopic single-site surgery
• minimally invasive laparoscopy
• pyeloplasty
• complications

OBJECTIVE
To review our initial series of laparoendoscopic single-site (LESS) pyeloplasties, focusing on 30-day complication rates as an indicator of learning curve, and to define the expected morbidity.
PATIENTS AND METHODS
The study comprised 28 patients who underwent LESS pyeloplasty by a single surgeon from October 2007.
A chart review was undertaken to identify the complications that occurred within the first 30 days after surgery.
RESULTS
The mean operating time was 197 min.
Seven patients (25%) experienced a total of eight complications. Four patients required nephrostomy tube placement (14%) during the early postoperative period, two for symptomatic obstruction despite the ureteral stent and two for a urine leak. Another had urine leakage that resolved spontaneously after she went home with the surgical drain for 1 week. One patient (4%) developed a retroperitoneal haematoma and required blood transfusion and one had haematuria that prolonged hospital stay by 2 days.
Of the patients experiencing complications, 71% were in the first ten cases. Only two complications occurred in the subsequent 18 patients.
CONCLUSIONS
The LESS pyeloplasty procedure is a technically difficult, even for an experienced laparoscopic surgeon and the surgical challenges of this technique may translate to a higher complication rate for LESS than for conventional laparoscopic pyeloplasty early in the learning curve. However, within a relatively few cases, the complication rate is similar to that of standard laparoscopic pyeloplasty.
Additional follow-up is required to determine the long-term success rate.

• 出版日期2011-10