title: Retroperitoneal laparoendoscopic single-site ureterolithotomy: a comparison with conventional laparoscopic surgery.
abstract: OBJECTIVE
  Laparoendoscopic single-site (LESS) surgery through the retroperitoneal approach has been seldom reported. We aimed to compare the feasibility and outcomes of LESS and conventional laparoscopic surgery via the retroperitoneal approach in the management of large, impacted ureteral stones.
  
  
  METHODS
  From June 2010 to May 2011, LESS ureterolithotomy through the retroperitoneal approach was performed in 10 patients (the LESS group). Another 15 patients who underwent conventional retroperitoneal laparoscopic ureterolithotomy (the conventional laparoscopic group) by the same surgeon were involved and compared. The operative time, complications, and surgical outcomes were evaluated.
  
  
  RESULTS
  All the operations were completed successfully, without conversion to conventional laparoscopic or open surgeries. The operative time of the LESS group and of the conventional laparoscopic group were 132.7±16.3 and 128.1±20.1 minutes, respectively (P=0.782). The estimated blood loss were 30.7±5.9 vs 28.0±4.5 mL (P=0.620). Duration of analgesia postoperatively was 2.0±0.8 vs 3.5±0.5 days (P=0.005). All targeted stones were successfully extracted without major complications. Postoperative urine leakage was noted in one patient in each group. Cosmetic results were superior in the LESS group according to both the study nurse's and the patients' assessments (8.5 vs 5.3; P=0.012, and 8.3 vs 5.6; P=0.025, respectively). All patients showed no obstructions or stricture formations on postoperative follow-up.
  
  
  CONCLUSIONS
  In experienced hands, LESS for ureterolithotomy through the retroperitoneal approach is feasible and can acquire outcomes equal to those of conventional multiport laparoscopic surgery. Prospective long-term follow-up studies with a larger number of patients are needed to further evaluate its benefits.
authors: Department of Urology, Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, China. xingqiaowen@yahoo.com
authors: Xingqiao
authors: X
authors: Wen
authors: Xiaopeng
authors: X
authors: Liu
authors: Huaiqiu
authors: H
authors: Huang
authors: Jieying
authors: J
authors: Wu
authors: Wentao
authors: W
authors: Huang
authors: Songwang
authors: S
authors: Cai
authors: Xiaojuan
authors: X
authors: Li
authors: Chunwei
authors: C
authors: Ye
authors: Baoyi
authors: B
authors: Zhu
authors: Yi
authors: Y
authors: Cai
authors: Xin
authors: X
authors: Gao
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012187:Retroperitoneal Space / Q000601:surgery*; D013525:Surgical Instruments; D013536:Suture Techniques; D014513:Ureter / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*