Introduction: We aimed to present the first prospective randomized comparison between laparoendoscopic single-site surgery (LESS) and minilaparoscopy (ML) radical nephrectomy for treatment of renal neoplasms.
Methods: Between January 2016 and January 2018, 30 patients were allocated and blindly randomized to either LESS radical nephrectomy (LESS RN, n=15) or ML radical nephrectomy (ML RN, n=15). Both cohorts were compared regarding demographic data, peri- and postoperative characteristics, and visual analogue pain scale (VAS). Cosmetic outcome was assessed after 6 months using patient scar assessment scale (PSAS) and observer scar assessment scale (OSAS).
Results: Mean operative time was 142.7±16.3 and 97.60±25.6 minutes in LESS and ML groups, respectively (P< 0.05). Mean estimated blood loss was 70.67±43.67 and 56±23.54 mL in both groups, respectively (P > 0.05). Mean VAS was 2.07±0.26 and 2.27±0.46 in both groups, respectively (P= 0.07). Mean PSAS and OSAS was 6.53±6.53 and 7.00±0.93 vs 9.8±2 and 9.73±1.67 in both groups, respectively (P< 0.05). There were no intraoperative complications, conversions to open surgery, or to conventional laparoscopy in both groups. No additional port was used in LESS RN. There was no significant difference in the postoperative complications according to the Clavien-Dindo system nor in hospital stay in both groups.
Conclusions: Both LESS RN and ML RN are valid options for treatment of renal neoplasms. They have comparable results in terms of blood loss, complication rate, VAS and hospital stay. However, LESS is associated with longer operative time and better cosmesis Source of
.jpg "Ahmed Mohamed Aboulkhair, MD photo")