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[Efficacy and safety of transumbilical single-port laparoscopic radical nephrectomy].

OBJECTIVE
To evaluate the efficacy and safety of transumbilical single-port laparoscopic radical nephrectomy.


METHODS
The clinical data of laparoscopic radical nephrectomy performed from June 2010 to October 2010 in Peking University Third Hospital were analyzed retrospectively. In the study, 10 patients underwent transumbilical single-port laparoscopic radical nephrectomy (LESS) and 15 received retroperitoneal laparoscopic radical nephrectomy. The data on general presentation, tumor size, tumor location, operative time, blood loss, complications, Visual Analog Pain Scale (VAPS), postoperative hospital stay, pathological results were collected to compare between the two groups. Our homemade single-site equipment was used in the LESS approach and the kidney was dissociated after being cut off the renal vessel and extracted through the umbilical incision. The retroperitoneal approach followed the standard surgical procedures, and the specimens were removed from the extended incision.


RESULTS
All the procedures were completed without conversion to open radical nephrectomy. Compared with traditional laparoscopic surgery, the operative time (P=0.001) and VAPS (P=0.002) showed significant difference in LESS group,and no difference was noted in other factors (P>0.05). There was no secondary bleeding, wound infection, intestinal obstruction, incision hernia and other severe postoperative complications. The follow-up of 6 to 10 months showed no local recurrence.


CONCLUSION
Transumbilical single-port laparoscopic radical nephrectomy is feasible, effective and safe. It gives a more mini-invasive and cosmetic option for young or female patients.