Initial experience of laparoendoscopic single-site nephroureterectomy with bladder cuff excision for upper urinary tract urothelial carcinoma performed by a single surgeon

Joo Yong Lee, Sang Jin Kim, Hong Sang Moon, Yong Tae Kim, Tchun Yong Lee, Sung Yul Park

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Purpose: To present our experience with the first 10 consecutive cases of laparoendoscopic single-site nephroureterectomy (LESSNU) with bladder cuff excision for upper tract urothelial carcinoma. Patients and Methods: Ten patients (6 men and 4 women; 6 renal pelvis and 4 ureter) underwent LESSNU by a single surgeon. We made a 4-cm single incision at the umbilicus using a homemade single-port device. The single-port device was made with a surgical glove and Alexis wound retractor. LESSNU was performed by the same technique of conventional laparoscopic NU. Results: The mean age was 62.79±7.93 years. The mean total operative time, time for nephrectomy, and time for bladder cuff excision were 225.63±65.87, 80.00±29.03, and 145.63±42.63 minutes. The mean estimated blood loss was 187.50±83.45 mL. On surgical pathologic examination, four patients were pT1N0, four patients were pT2N0, one patient was pT3N 0, and one patient was pT3N2. There was one positive surgical margin in a pT3N2 patient. The mean number of lymph nodes dissected was 2.5 (range 0-9). One incision extension was performed because of complete renal hilar lymphadenectomy by open technique (for the pT3N2 patient), and one open conversion with a Gibson incision was performed because of severe adhesions around the distal ureter (the pT3N0 patient). There were one case of transient ileus and one of fever that were improved with conservative treatment. The mean hospital stay was 4.75±3.37 days. Eight patients who underwent LESSNU successfully were satisfied with their operations. Conclusions: LESSNU for upper urinary tract urothelial carcinoma seems to be feasible and safe, but it is still challenging for advanced cases.

Original languageEnglish
Pages (from-to)1763-1768
Number of pages6
JournalJournal of Endourology
Volume25
Issue number11
DOIs
StatePublished - 2011 Nov 1

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