Single-port laparoscopic retroperitoneal surgery: initial operative experience and comparative outcomes.

摘要

OBJECTIVES: To present the initial operative outcomes and comparative data among patients undergoing single-port laparoscopic retroperitoneal surgery (SPLRS). METHODS: A prospective, observational study of all patients who underwent SPLRS was performed. The salient demographic and operative data, including age, body mass index, operative indications, operative time, estimated blood loss, complications, and postoperative visual analog pain scale scores were recorded. Patients who underwent cryoablation were then retrospectively compared to a contemporary, matched cohort of patients undergoing traditional laparoscopic retroperitoneal cryosurgery. Statistical analyses were performed. RESULTS: From September 25, 2007 to July 15, 2008, 8 patients underwent SPLRS. Five patients underwent SPLR cryoablation and 1 underwent SPLR partial nephrectomy for radiographic evidence of an enhancing renal mass. One patient underwent SPLR metastectomy for isolated recurrence of renal cell carcinoma. The remaining patient underwent SPLR cyst decortication for unrelenting pain. The mean patient age was 63.5 years. The mean body mass index was 28.9 kg/m(2). The mean operative time and estimated blood loss was 165 +/- 23 minutes and 134 +/- 152 mL, respectively. No intraoperative or postoperative complications were noted. The mean hospitalization was 1.4 days. The mean visual analog pain scale score at discharge was 0.4 of 10 (range 0-2). No significant difference was noted between the single-port and standard retroperitoneal cryotherapy cohorts with respect to age, body mass index, estimated blood loss, and length of hospitalization (P > .05). Patients who underwent SPLR cryoablation reported lower visual analog pain scale scores (P = .023). CONCLUSIONS: The results of our study have shown that SPLRS is feasible and offers comparable surgical outcomes and superior cosmesis and pain control compared with traditional retroperitoneoscopy.