University of Southern California, CA, USA.
BJU Int. 2012 Mar;109(6):910-5. doi: 10.1111/j.1464-410X.2011.10524.x. Epub 2011 Aug 23.
To compare the perioperative parameters of paediatric patients who underwent nephrectomy via laparo-endoscopic single site (LESS) surgery (also known as single incision laparoscopic surgery or SILS) with those who underwent nephrectomy via conventional laparoscopy (LAP), robotic-assisted laparoscopy (RALN), and open surgery (OPEN).
The medical records of 69 paediatric patients at a single institution who underwent nephrectomies for non-functioning kidneys in 72 renal units (39 OPEN, 11 LAP, 11 RALN and 11 LESS) were reviewed for patient demographics and perioperative clinical parameters.
The minimally invasive modalities in children, including LESS nephrectomy, were associated with shorter lengths of hospital stay (P < 0.001) and decreased postoperative pain medication usage (P < 0.001) than with open surgery. Similar surgical times were noted with LESS and the other minimally invasive modalities (LAP and RALN) (P= 0.056). However, the minimally invasive modalities (LESS, LAP and RALN) were associated with slightly longer surgical times when compared with open surgery (P < 0.001), which may, in part, be secondary to learning curve factors. No differences were noted among the minimally invasive modalities for postoperative pain medication usage (P= 0.354) and length of hospital stay (P= 0.86).
The minimally invasive modalities for nephrectomy in children, including LESS nephrectomy, are associated with shorter lengths of hospital stay and decreased postoperative pain medication use when compared with open surgery. LESS nephrectomy in children is associated with similar surgical times, lengths of hospital stay and postoperative pain medication use as the other minimally invasive modalities (LAP and RALN). Slightly longer surgical times are noted with the minimally invasive modalities, including LESS nephrectomy, when compared with open surgery, which may, in part, be secondary to learning curve factors.
比较经腹腔镜单部位（LESS）手术（也称为单切口腹腔镜手术或 SILS）、传统腹腔镜（LAP）、机器人辅助腹腔镜（RALN）和开放性手术（OPEN）治疗小儿患者的围手术期参数。
回顾性分析了一家机构 72 个肾脏单位中 69 例接受肾切除术的儿童患者的病历资料，这些患者均因无功能肾脏而接受手术，其中 39 例接受 OPEN 手术，11 例接受 LAP 手术，11 例接受 RALN 手术，11 例接受 LESS 手术。
LESS 肾切除术等微创方式与开放性手术相比，住院时间更短（P<0.001），术后止痛药使用量更少（P<0.001）。LESS 手术与其他微创方式（LAP 和 RALN）的手术时间相似（P=0.056）。然而，与开放性手术相比，微创方式（LESS、LAP 和 RALN）的手术时间略长（P<0.001），这可能部分是由于学习曲线因素。在术后止痛药使用量（P=0.354）和住院时间（P=0.86）方面，微创方式之间无差异。
与开放性手术相比，小儿经LESS 肾切除术等微创方式的住院时间更短，术后止痛药使用量更少。LESS 肾切除术在手术时间、住院时间和术后止痛药使用量方面与其他微创方式（LAP 和 RALN）相似。与开放性手术相比，微创方式（包括 LESS 肾切除术）的手术时间略长，这可能部分是由于学习曲线因素。
