Song Jia-Ao, Xu Yi-Fan, Liu Wen-Qiang, Xiao Cheng-Wu, Liu Bing, Carbonara Umberto, Campi Riccardo, Zhu Jian-Guo, Wang Lin-Hui, Wu Zhen-Jie
Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy.
Transl Androl Urol. 2023 Jan 30;12(1):90-96. doi: 10.21037/tau-22-863. Epub 2023 Jan 1.
Laparoendoscopic single-site (LESS) surgery is performed to further narrow the incisions and reduce tissue injury. It has been more than10 years since the surgery was first described. However, there is still no report on the results of 10-year follow-up. This study evaluated the use of long-term oncology and the renal outcomes of LESS radical nephrectomy (LESS-RN) in the treatment of localized renal cancer.
We retrospectively analyzed the clinical data of patients treated with LESS-RN at Changhai Hospital from 2009 to 2012. Patients with localized kidney cancer who were followed-up for at least 10 years were included in the study. The baseline data and major perioperative outcome variables were analyzed. Overall survival (OS) and cancer-specific survival (CSS) were calculated using the Kaplan-Meier method.
A total of 48 patients were included in the study, which had a median follow-up of 11 years (interquartile range, 10.7-11.8 years). The 10-year OS and CSS rates were 87.5% [42/48; 95% confidence interval (CI): 0.778-0.972] and 97.9% (47/48; 95% CI: 0.937-1.021), respectively. At the most recent follow-up, there were 5 patients with a chronic kidney disease stage ≥3. Among these 5 patients, 3 developed uremia and required continuous dialysis.
For localized renal cancer, LESS-RN is safe and effective with excellent long-term oncology controllability and good functional outcomes. Prospective studies with large sample sizes need to be conducted to validate our results.
腹腔镜单孔手术（LESS）旨在进一步缩小切口并减少组织损伤。自该手术首次被描述以来已有十多年。然而，尚无关于10年随访结果的报告。本研究评估了LESS根治性肾切除术（LESS-RN）在治疗局限性肾癌中的长期肿瘤学疗效及肾脏结局。
我们回顾性分析了2009年至2012年在长海医院接受LESS-RN治疗的患者的临床资料。纳入研究的是随访至少10年的局限性肾癌患者。分析了基线数据和主要围手术期结局变量。采用Kaplan-Meier法计算总生存期（OS）和肿瘤特异性生存期（CSS）。
本研究共纳入48例患者，中位随访时间为11年（四分位间距为10.7 - 11.8年）。10年OS率和CSS率分别为87.5%[42/48；95%置信区间（CI）：0.778 - 0.972]和97.9%（47/48；95%CI：0.937 - 1.021）。在最近一次随访时，有5例患者慢性肾脏病分期≥3期。在这5例患者中，3例发展为尿毒症并需要持续透析。
对于局限性肾癌，LESS-RN安全有效，具有出色的长期肿瘤学可控性和良好的功能结局。需要进行大样本量的前瞻性研究来验证我们的结果。
