title: Complications during the initial experience with laparoendoscopic single-site pyeloplasty.
abstract: OBJECTIVE
  • To review our initial series of laparoendoscopic single-site (LESS) pyeloplasties, focusing on 30-day complication rates as an indicator of learning curve, and to define the expected morbidity.
  
  
  METHODS
  • The study comprised 28 patients who underwent LESS pyeloplasty by a single surgeon from October 2007. • A chart review was undertaken to identify the complications that occurred within the first 30 days after surgery.
  
  
  RESULTS
  • The mean operating time was 197 min. • Seven patients (25%) experienced a total of eight complications. Four patients required nephrostomy tube placement (14%) during the early postoperative period, two for symptomatic obstruction despite the ureteral stent and two for a urine leak. Another had urine leakage that resolved spontaneously after she went home with the surgical drain for 1 week. One patient (4%) developed a retroperitoneal haematoma and required blood transfusion and one had haematuria that prolonged hospital stay by 2 days. • Of the patients experiencing complications, 71% were in the first ten cases. Only two complications occurred in the subsequent 18 patients.
  
  
  CONCLUSIONS
  • The LESS pyeloplasty procedure is a technically difficult, even for an experienced laparoscopic surgeon and the surgical challenges of this technique may translate to a higher complication rate for LESS than for conventional laparoscopic pyeloplasty early in the learning curve. However, within a relatively few cases, the complication rate is similar to that of standard laparoscopic pyeloplasty. • Additional follow-up is required to determine the long-term success rate.
authors.affiliation: The University of Texas Southwestern Medical Center at Dallas, TX, USA.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Best
authors.forename: Chester
authors.initials: C
authors.lastname: Donnally
authors.forename: Saad A
authors.initials: SA
authors.lastname: Mir
authors.forename: Chad R
authors.initials: CR
authors.lastname: Tracy
authors.forename: Jay D
authors.initials: JD
authors.lastname: Raman
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D014572:Urology / Q000592:standards