title: Upper Tract Urological Laparoendoscopic Single-Site Surgery (LESS).
abstract: OBJECTIVE
  Our objective is to report intermediate-term outcomes for patients who have undergone upper tract urologic laparoendoscopic single-site surgery (LESS) at a single institution.
  
  
  METHODS
  From January 1, 2008, through November 30, 2012, 107 cases treated with LESS were identified, including pyeloplasty (n = 30), ureterolithotomy (n = 32), nephrectomy (n = 35; simple = 31, partial = 4), and cyst decortication (n = 10). Perioperative data were reviewed, and conversion and complication rates were noted.
  
  
  RESULTS
  The median follow-up was 21.5 months for pyeloplasty, 20.5 for ureterolithotomy, 28.0 for simple nephrectomy, 14.0 for partial nephrectomy, and 19.0 for cyst decortication. Major complications were encountered in 8 patients, including 3 intraoperative complications (2 bowel injury with serosal tearing and 1 intraoperative bleeding), which were recognized and repaired with LESS or conversion to conventional laparoscopy (CL). During the intermediate postoperative period (30-90 days) major complications occurred in 5 patients: 4 ureteral strictures (Clavien-Dindo grade [CG] IIIb) and 1 urinoma formation (CG IIIa). During the early postoperative period (<30 days), the most common minor complications were flank pain (CG I) in 16 patients and urinary tract infection (CG II) in 11, followed by urinary leakage (CG I) in 8.
  
  
  CONCLUSIONS
  Intermediate-term functional outcomes of this single-center study confirm that upper tract LESS is a challenging procedure that can be safe and effective when performed by an experienced team. Prospective studies with longer follow-up periods are needed to investigate the safety of LESS in the treatment of various upper urinary tract conditions.
authors.affiliation: Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Tugcu
authors.affiliation: Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Arda
authors.initials: A
authors.lastname: Atar
authors.affiliation: Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Sahin
authors.affiliation: Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Seker
authors.affiliation: Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Kargi
authors.affiliation: Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali Ihsan
authors.initials: AI
authors.lastname: Tasci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult
keywords: LESS complications; Laparoendoscopic single-site surgery; Single-center study; Upper urinary tract surgery