E. Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .
J Endourol. 2014 Jun;28(6):675-8. doi: 10.1089/end.2013.0735. Epub 2014 Feb 11.
Nephroureterectomy (NU) with bladder cuff excision is the gold standard treatment for patients with upper urinary tract urothelial cancer. We report our initial experience with laparoendoscopic single-site plus one port (LESS POP) technique for NU and bladder cuff excision.
We retrospectively reviewed the records of consecutive patients undergoing LESS POP NU between 2011 and 2012. We describe in detail our surgical technique and summarized the outcomes in this initial series.
Ten patients (7 male, 3 female) aged 55 to 84 years underwent LESS POP NU. There were no conversions to open technique or additions of conventional laparoscopic ports. Median (range) operative time was 217 minutes. Specimens were extracted through the umbilical incision in five patients and through an extension of the lower quadrant port in five. One patient experienced urine leak followed by umbilical wound dehiscence (Clavien grade IIIb complication).
In this series, LESS POP NU was feasible with encouraging outcomes. We believe that it is possible to extend the benefits of LESS to patients with upper tract tumors while adhering to strict oncologic principles.
肾输尿管切除术（NU）加膀胱袖状切除术是上尿路尿路上皮癌患者的金标准治疗方法。我们报告了我们使用腹腔镜单部位加单端口（LESS POP）技术进行 NU 和膀胱袖状切除术的初步经验。
我们回顾性分析了 2011 年至 2012 年间连续接受 LESS POP NU 治疗的患者的记录。我们详细描述了我们的手术技术，并总结了该初始系列的结果。
10 名 55 至 84 岁的男性和女性患者接受了 LESS POP NU。没有转换为开放技术或增加传统腹腔镜端口。中位（范围）手术时间为 217 分钟。5 名患者通过脐部切口取出标本，5 名患者通过下腹部端口延长部取出标本。1 例患者发生尿漏，随后出现脐部伤口裂开（Clavien 分级 IIIb 并发症）。
在本系列中，LESS POP NU 是可行的，结果令人鼓舞。我们相信，通过严格遵循肿瘤学原则，有可能将 LESS 的益处扩展到上尿路肿瘤患者。
