Single institution, randomized study to compare the efficacy and safety between laparoendoscopic single-site (LESS) surgery and conventional laparoscopic surgery for Uretero-Pelvic Junction (UPJ) stone

• Main Authors: Ab Rashid, Islah Munjih, Sung, Yong Cho, Yong, Hyun Park, Son, Hwancheol, Hyeon, Hoe Kim, Seung, Bae Lee, Hyeon, Jeong
• Format: Conference or Workshop Item
• Language: English
• Published: 2013
• Subjects: RD Surgery
• Online Access: http://irep.iium.edu.my/44593/1/AUA_San_Diego_PDF.pdf; http://irep.iium.edu.my/44593/; https://www.auanet.org/university/abstract_detail.cfm?id=1555&meetingID=13SAN

Introduction and Objectives LESS has slowly adopted its role in current urological practice. The objective of our study is to confirm the efficacy and safety of laparoendoscopic single-site surgery (LESS) compared to conventional laparoscopic surgery for upper urinary tract stones Methods Patients with UPJ stones with maximum diameter over 1.5cm and concomitant hydroureteronephrosis within recent 1 year were included. The surgery was done by two experienced laparoscopic surgeons. The patients were randomly assigned into two groups as conventional laparoscopy group and LESS group. 10 patients were included in each group. Surgical methods were all the same except for the number of incision. OctoportTM was used in the LESS group. We approached the area of interest transperitoneally with medial traction of the colon. An incision was then made at the Ureteropelvic junction to gain access to the stones. We used the flexible ureteroscope to remove the remaining calyceal stones after the main UPJ stone has been removed. Intraoperative ureteral stents were inserted antegradely. Mann-Whitney U-test and chi-square test were used to compare factors of patients, stones, and surgery between the two groups. Results There was no difference between the two groups in preoperative factors. There was no difference in operative time, estimated intraoperative blood loss, duration of indwelling urethral catheter, length of hospital stay, postoperative pain scores before discharge and change in renal function. There was no difference in analgesic use and complication rates. According to Clavien classification, there were two cases of IIIa at CL group, and there was no case of more than IIIa at LESS group. There was no conversion to open surgery at both groups. The incidence of residual stones which were found in CT 1 month after surgery was 40% at both group, but the size of all stones was 4mm or less. Conclusions LESS showed the equivalent effectiveness and safety compared to CL surgery for the treatment of upper urinary tract stones.