Duration of the laparoendoscopic single site nephrectomy learning curve

Kotov S.V., Kolmakov A.S., Pul'bere S.A., Guspanov R.I., Mazurenko D.A.

Introduction: Currently, the treatment standard of patients with renal masses and a nonfunctional kidney are endovideo-surgical operations, among which the least invasive are laparoendoscopic single-site (LESS) operations.

Objective: Studying of the LESS nephrectomy (LESS-N) learning curve, its effect on the operations results, and comparative analysis of the LESS -N and conventional laparoscopic nephrectomy (CLN) results.

Materials and methods: The work is based on the treatment results of 79 patients. There were 37 patients undergoing LESS-N, and 42 - CLN. Surgical indications were renal masses (89%), and nonfunctional kidney (11%). Patients of both groups were comparable by sex, age, BMI, and concomitant illness. In the LESS-N group all operations were performed by a single surgeon, who had no experience of LESS-N, but had stable results of CLN. In the CLN group, all operations were performed by a single surgeon, who had no experience of performing CLN. Learning curve was passed after achieving a stable low rate of perioperative complications.

Results: In LESS -N group learning curve was 21 operations. Comparative analysis of the LESS-N and CLN main perioperative results (operation time, length of hospital stay, volume of intraoperative blood loss) didn’t show any difference between two groups.

Conclusion: If a surgeon has stable results of CLN, LESS-N learning curve was not less 21 operations. After passing the learning, LESS -N can be an operation of chose for patients with renal tumor nonfunctional kidney.

Authors declare lack of the possible conflicts of interests

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laparoendoscopic single-site surgery, nephrectomy, learning curve