Comparison of Laparoendoscopic Single-Site Radical Nephrectomy with Conventional Laparoscopic Radical Nephrectomy for Localized Renal-Cell Carcinoma

Purpose: To compare the results of laparoendoscopic single-site (LESS) radical nephrectomy with conventional laparoscopic radical nephrectomy for localized renal-cell carcinoma (RCC). Patients and Methods: This study was designed as a matched case-controlled study from our institute's RCC database. Nineteen consecutive patients who were undergoing LESS radical nephrectomy were compared with 38 patients who were undergoing conventional laparoscopic radical nephrectomy. The matching process accounted for sex, age, operative side, and tumor size. Results: No significant differences were observed in mean operative time (190.8 vs 172.4 min, P - 0.249), estimated blood loss (143.2 vs 199.5 mL, P - 0.235), and complication rate (15.8% vs 21.1 %, P - 0.635) between the LESS and conventional laparoscopy groups. Postoperative hospital stay after LESS radical nephrectomy was 2.7 (2-4) days, compared with 3.9 (3-7) days in the conventional laparoscopy group (P < 0.001). Postoperative pain, as measured by visual analog scale at postoperative day 1 (4.7 vs 5.8 points, P - 0.001), 2 (3.4 vs 4.6 points, P < 0.001), and 3 (2.7 vs 4.0 points, P = 0.008) was significantly lower in the LESS group. Conclusion: LESS radical nephrectomy is a feasible and safe surgical option for localized RCC that demonstrates improved cosmetic outcomes and the additional benefits of decreased postoperative pain and decreased hospital stay.