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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Urological laparoendoscopic single site surgery: Multi-institutional analysis of risk factors for conversion and postoperative complications
Journal of Urology, Volume 187, No. 6, Year 2012
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Description
Purpose: We analyzed the incidence of and risk factors for complications and conversions in a large contemporary series of patients treated with urological laparoendoscopic single site surgery. Materials and Methods: The study cohort consisted of consecutive patients treated with laparoendoscopic single site surgery between August 2007 and December 2010 at a total of 21 institutions. A logistic regression model was used to analyze the risks of conversion, and of any grade and only high grade postoperative complications. Results: Included in analysis were 1,163 cases. Intraoperatively complications occurred in 3.3% of cases. The overall conversion rate was 19.6% with 14.6%, 4% and 1.1% of procedures converted to reduced port laparoscopy, conventional laparoscopic/robotic surgery and open surgery, respectively. On multivariable analysis the factors significantly associated with the risk of conversion were oncological surgical indication (p = 0.02), pelvic surgery (p <0.001), robotic approach (p <0.001), high difficulty score (p = 0.004), extended operative time (p = 0.03) and an intraoperative complication (p = 0.001). A total of 120 postoperative complications occurred in 109 patients (9.4%) with major complications in only 2.4% of the entire cohort. Reconstructive procedure (p = 0.03), high difficulty score (p = 0.002) and extended operative time (p = 0.02) predicted high grade complications. Conclusions: Urological laparoendoscopic single site surgery can be done with a low complication rate, resembling that in laparoscopic series. The conversion rate suggests that early adopters of the technique have adhered to the principles of careful patient selection and safety. Besides facilitating future comparisons across institutions, this analysis can be useful to counsel patients on the current risks of urological laparoendoscopic single site surgery. © 2012 American Urological Association Education and Research, Inc.
Authors & Co-Authors
Autorino, Riccardo
United States, Cleveland
Cleveland Clinic Foundation
Kaouk, Jihad H.
United States, Cleveland
Cleveland Clinic Foundation
Yakoubi, Rachid
United States, Cleveland
Cleveland Clinic Foundation
Rha, Koonho
South Korea, Seoul
Yonsei University College of Medicine
Stein, Robert J.
United States, Cleveland
Cleveland Clinic Foundation
White, Wesley M.
United States, Knoxville
University of Tennessee Medical Center
Stolzenburg, Jens Uwe
Germany, Leipzig
Universität Leipzig
Cindolo, Luca
Italy
S. Pio da Pietralcina Hospital
Liatsikos, Evangelos N.
Greece, Rio
School of Medicine of Patras University
Rais-Bahrami, Soroush
United States, Hempstead
Donald and Barbara Zucker School of Medicine at Hofstra/northwell
Volpe, Alessandro
Italy, Vercelli
Università Degli Studi Del Piemonte Orientale Amedeo Avogadro
Han, Deok Hyun
South Korea, Seoul
Sungkyunkwan University
Derweesh, Ithaar H.
United States, La Jolla
University of California, San Diego
Lee, Seung Wook
South Korea, Seoul
Hanyang University
Abdel-Karim, Aly M.
Egypt, Alexandria
Faculty of Medicine
Branco, Anibal
Brazil, Curitiba
Cruz Vermelha Hospital
Greco, Francesco
Germany, Halle
Martin-luther-universität Halle-wittenberg
Allaf, Mohammad
United States, Baltimore
Johns Hopkins Medicine
Sotelo, Rene
Venezuela, Caracas
Instituto Médico la Floresta
Kallidonis, Panagiotis S.
Greece, Rio
School of Medicine of Patras University
Jeong, Byong Chang
South Korea, Seoul
Sungkyunkwan University
Best, Sara
United States, Richardson
The University of Texas at Dallas
Bazzi, Wassim
United States, La Jolla
University of California, San Diego
Pierorazio, Phillip Martin
United States, Baltimore
Johns Hopkins Medicine
Elsalmy, Salah
Egypt, Alexandria
Faculty of Medicine
Rané, Abhay R.M.
United Kingdom, Redhill
East Surrey Hospital
Han, Woongkyu
South Korea, Seoul
Yonsei University College of Medicine
Yang, Bo
China, Shanghai
Changhai Hospital
Schips, Luigi
Italy
S. Pio da Pietralcina Hospital
Molina, Wilson R.
United States, Denver
Denver Health Med Center
Fornara, Paolo
Germany, Halle
Martin-luther-universität Halle-wittenberg
Terrone, Carlo
Italy, Vercelli
Università Degli Studi Del Piemonte Orientale Amedeo Avogadro
Giedelman, Camilo
Venezuela, Caracas
Instituto Médico la Floresta
Lee, Joo Yong
South Korea, Seoul
Yonsei University College of Medicine
Crouzet, Sebastien
France, Lyon
Hopital Edouard Herriot
Haber, Georges Pascal
United States, Cleveland
Cleveland Clinic Foundation
Richstone, Lee
United States, Hempstead
Donald and Barbara Zucker School of Medicine at Hofstra/northwell
Sun, Yinghao Haon
China, Shanghai
Changhai Hospital
Kim, Fernando J.
United States, Denver
Denver Health Med Center
Cadeddu, Jeffrey A.
United States, Richardson
The University of Texas at Dallas
Statistics
Citations: 53
Authors: 40
Affiliations: 21
Identifiers
Doi:
10.1016/j.juro.2012.01.062
ISSN:
00225347
e-ISSN:
15273792
Research Areas
Health System And Policy
Study Design
Cohort Study