title: Laparoendoscopic single-site nephrectomy and heminephroureterectomy in children using standard laparoscopic setup versus conventional laparoscopy.
abstract: OBJECTIVE
  To investigate the safety and effectiveness of laparoendoscopic single-site surgery (LESS) using standard laparoscopic setup in pediatric nephrectomy/heminephroureterectomy (HN) by comparing with conventional laparoscopy (CL).
  
  
  METHODS
  Twelve consecutive children who underwent LESS (nephrectomy = 8, HN = 4) from 2009 to 2012 were compared with a matched cohort of 18 children who underwent CL (nephrectomy = 12, HN = 6) at the same institution. Data were reviewed retrospectively.
  
  
  RESULTS
  There was no difference between the 2 groups in the age of patients, body weight, gender distribution, laterality of pathology, postoperative analgesic requirement, and hospital stay. Eleven of the 12 children in the LESS group underwent the procedure successfully without additional trocar placement. The only open conversion happened in the case of LESS of the lower moiety HN. LESS nephrectomy took longer operative time than CL (mean 156 +/- 45 vs 99 +/- 35 minutes, median 155 vs 90 minutes, P <.01). Wound infection occurred in 1 patient after CL nephrectomy. No postoperative complication or access site hernia was noted in the children in the LESS group at follow-up.
  
  
  CONCLUSIONS
  LESS nephrectomy and HN in the pediatric population is safe and effective with a minimally invasive nature comparable to CL. Learning curve factors may contribute to the reported longer operative time in LESS. Further studies are required to investigate the implication of patient selection and the cosmetic benefits of LESS, which may potentially require longer operative time.
authors: Division of Pediatric Surgery and Pediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. pyhtam@surgery.cuhk.edu.hk
authors: Yuk Him
authors: YH
authors: Tam
authors: Kristine Kit Yi
authors: KK
authors: Pang
authors: Siu Yan
authors: SY
authors: Tsui
authors: Yuen Shan
authors: YS
authors: Wong
authors: Hei Yi
authors: HY
authors: Wong
authors: Jennifer Wai Cheung
authors: JW
authors: Mou
authors: Kin Wai
authors: KW
authors: Chan
authors: Christopher H
authors: CH
authors: Houben
authors: Jennifer Dart Yin
authors: JD
authors: Sihoe
authors: Kim Hung
authors: KH
authors: Lee
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D021782:Multicystic Dysplastic Kidney / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D014513:Ureter / Q000601:surgery*