Comparison of standard laparoscopic nephrectomy with laparoendoscopic single site nephrectomy

Objectives: In this prospective study, it is aimed to compare standard laparoscopic neprectomy with laparoendoscopic single site nephrectomy, according to parameters such as operation time, estimated blood loss, intraoperative and postoperative complications, pain score, analgesic use, hospitalization time, time needed to return to daily life and work, quality of life, patient satisfaction, and cost of the procedure.Material and Methods: Between January 2009 and September 2011, transperitoneal simple nephrectomy performed patients older than 10 years old, who have simple nephrectomy indication because of benign diseases, 18 single-port transperitoneal laparoscopic nephrectomy and 19 standard transperitoneal laparoscopic nephrectomy applied to the patients. The results were analysed with statistical methods.Results: In statistical evaluation; there was no significant difference between two groups in terms of intraoperative complications (p=0,677). Average hospital stay of standart laparoscopic neprectomy was longer than single-port laparoscopic nephrectomy, this difference was not statistically significant (p=0,435).Visual Pain Scale scores of both groups showed decline in every measurement in a statistically significant way (p=<0,001). When total costs were examined, both groups were similar (p=0,076).Discussion: It is seen that in becoming widespread single-port surgery, cosmetic results are better than standard surgery; analgesic need and complication rates are similar with standard surgery, complete convalescence, and time to return daily life was faster. Patient satisfaction was higher. Higher material costs and obligation of need of laparoscopic experience for surgeon's adaptation to new hand devices with new operation technics are disadvantages of single-port laparoscopic nephrectomy. TPLN, laparoscopy in experienced centers, chosen primarily cosmetic can be used safely in patients with more than expectation.This study in patients undergoing laparoscopy with a standart or a single port, postoperative satisfaction, quality of life and cost are important in terms of parameters such as to give comparable results at the same time, this is the first study in this area.Key Words: Laparoscopy, single port, nephrectomy, complication, quality of life.