2nd Department of Urology, Aristotle University of Thessaloniki, Greece; Surgery Working Group, Society of Junior Doctors, Athens, Greece.
Surgery Working Group, Society of Junior Doctors, Athens, Greece.
Int J Surg. 2016 May;29:53-61. doi: 10.1016/j.ijsu.2016.03.040. Epub 2016 Mar 19.
Improvements in laparoscopic surgery have led to the introduction of laparoendoscopic single-site surgery (LESS) as an alternative to conventional laparoscopy conferring a number of possible advantages. In this review, we aim to elucidate the aspects of LESS for major urological procedures in the pediatric population.
An in-depth search of the literature was performed in the databases of PubMed and Scopus, for studies investigating the technical aspects and clinical outcomes of partial nephrectomies, nephrectomies, nephroureterectomies, varicocelectomies and pyeloplasties in children. Data on parameters such as operation time, instrumentation, perioperative complications, hospital stay and follow up period were collected and further analyzed cumulatively.
Twenty nine studies met the inclusion criteria incorporating 386 patients who underwent 401 procedures. There were no major intraoperative complications, with only 19 patients (4.73%) facing postoperative complications. No perioperative deaths were reported.
In the hands of experienced surgeons LESS seems a feasible, efficient and less invasive alternative to standard laparoscopy in the field of pediatric urology. There is an eminent need of well-designed randomized controlled trials comparing the two techniques.
腹腔镜手术的改进促使了经脐单孔腹腔镜手术（LESS）的出现，作为传统腹腔镜手术的替代方法，LESS 具有许多潜在优势。在本综述中，我们旨在阐明 LESS 在儿科人群中进行主要泌尿外科手术的相关方面。
我们在 PubMed 和 Scopus 数据库中进行了深入的文献检索，以研究部分肾切除术、肾切除术、肾输尿管切除术、精索静脉结扎术和肾盂成形术的技术方面和临床结果。收集了手术时间、仪器使用、围手术期并发症、住院时间和随访期等参数的数据，并进行了累积分析。
符合纳入标准的 29 项研究共纳入 386 例患者，共进行了 401 例手术。术中无重大并发症，仅有 19 例（4.73%）患者发生术后并发症。无围手术期死亡病例。
在经验丰富的外科医生手中，LESS 似乎是一种可行、高效和微创的替代标准腹腔镜手术的方法，在小儿泌尿外科领域具有很大的应用前景。迫切需要设计良好的随机对照试验来比较这两种技术。
