title: Laparoendoscopic single-site versus conventional laparoscopic radical nephrectomy for renal cell cancer in patients with increased comorbidities and previous abdominal surgery: preliminary results of a single-centre retrospective study.
abstract: OBJECTIVE
  Laparoendoscopic single-site surgery (LESS) represents an evolution of laparoscopy for the treatment for urologic diseases. The aim of this study is to investigate the feasibility of LESS in patients with increased comorbidities and previous abdominal surgery undergoing radical nephrectomy (LESS-RN) for renal cell carcinoma.
  
  
  METHODS
  A total of 25 patients with increased comorbidities and previous abdominal surgery who underwent LESS-RN were compared to 31 patients with the same characteristics after conventional laparoscopic radical nephrectomy (LRN). LRN was performed between January 2009 and May 2010, and LESS-RNs were performed between June 2010 and November 2011. Demographic data and perioperative and postoperative variables were recorded and analysed.
  
  
  RESULTS
  The mean ASA score in the LESS-RN and LRN groups was 3.2 ± 0.4, and the mean BMI was 32.7 ± 2.1 and 34.2 ± 0.8 kg/m(2), respectively.                                                                 The mean operative time in the LESS-RN and LRN groups was 143.7 ± 24.3 and 130.6 ± 26.5 min, (p = 0.11), and the mean hospital stay was 3.8 ± 0.8 versus 4.2 ± 1.4 days in the two groups (p = 0.06), respectively.                                                                 Three and four complications were recorded in the LESS-RN and in the LRN groups, for a mean complication rate of 12 and 12.9 % (p = 0.12), respectively                                                                 All tumours were organ-confined with negative surgical margins, and the mean R.E.N.A.L nephrometry score for LESS-RN and LRN was 9.78 ± 1.7 and 9.82 ± 1.3 (p = 0.14), respectively.
  
  
  CONCLUSIONS
  LESS-RN in patients with increased comorbidities and previous abdominal surgery is equally effective as LRN without compromising on surgical, oncologic short-term and postoperative outcomes.
authors.affiliation: Department of Urology and Kidney Transplantation, Martin-Luther-University, Ernst-Grube-Strasse 40, 06120, Halle, Saale, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Springer
authors.forename: Antonino
authors.initials: A
authors.lastname: Inferrera
authors.forename: Felix
authors.initials: F
authors.lastname: Kawan
authors.forename: André
authors.initials: A
authors.lastname: Schumann
authors.forename: Paolo
authors.initials: P
authors.lastname: Fornara
authors.forename: Francesco
authors.initials: F
authors.lastname: Greco
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000601:surgery*; D015331:Cohort Studies; D003327:Coronary Disease / Q000150:complications; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009765:Obesity / Q000150:complications; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome