MP23-08 HYBRID TRANSVAGINAL NOTES NEPHRECTOMY VERSUS CONVENTIONAL LAPAROSCOPIC NEPHRECTOMY: A PROSPECTIVE, NONRANDOMISED TRIAL AT A SINGLE CENTER

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I1 Apr 2016MP23-08 HYBRID TRANSVAGINAL NOTES NEPHRECTOMY VERSUS CONVENTIONAL LAPAROSCOPIC NEPHRECTOMY: A PROSPECTIVE, NONRANDOMISED TRIAL AT A SINGLE CENTER Zou xiaofeng, Zhang guoxi, Xue yijun, Yuan yuanhu, Xiao rihai, and Wu gengqing Zou xiaofengZou xiaofeng More articles by this author , Zhang guoxiZhang guoxi More articles by this author , Xue yijunXue yijun More articles by this author , Yuan yuanhuYuan yuanhu More articles by this author , Xiao rihaiXiao rihai More articles by this author , and Wu gengqingWu gengqing More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.730AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent reports have suggested that transvaginal natural orifice translumenal endoscopic surgery nephrectomy (NOTES-N) is feasible and safe, yet clinical evidence with regard to the benefits of NOTES-N are absent. The aim of this study is to present a comparison between NOTES-N and conventional laparoscopic nephrectomy (LN) with respect to perioperative outcomes, cosmetic results and quality of life. METHODS This was a prospective nonrandomised comparative study of all female patients undergoing NOTES-N or LN at our institution between November 2012 and March 2014. The primary outcome was pain scores on days 1-5 after surgery using the visual analog scale (VAS). The secondary outcomes included comparison of surgical results, inflammatory response, postoperative convalescence, quality of life, and cosmetic result. Patient convalescence was assessed using the Convalescence and Recovery Evaluation (CARE) questionnaire. Quality of life was measured by a 36-item Health Survey (SF-36) questionnaire. Cosmetic result was assessed using a Patient Scar Assessment Questionnaire (PSAQ). Sexual function was evaluated with the Female Sexual Function Index (FSFI). Continuous variables with a normal distribution were analysed by Student t test. Variables without a normal distribution were analysed using Mann-Whitney U test. Categorical variables were compared using ?2 tests. RESULTS We enrolled 46 patients in the NOTES-N and 41 in the LN group; the two groups were comparable for all preoperative parameters. Operative time, estimated blood loss, rate of intra- and postoperative complications were similar in the 2 groups. NOTES-N resulted in a significant decrease in pain scores on days 1-5 after surgery. The mean C-reactive protein and interleukin 6 values were higher for LN at 24 h before surgery (p = 0.003 and 0.01), during surgery (p < 0.001 for both), at the end of anaesthesia (p < 0.001 for both) and 24 h after surgery (p < 0.001 for both), respectively. The NOTES-N group demonstrated CARE higher activity scores at 2 wk (p = 0.007) and 4 wk (p = 0.026), as well as CARE higher pain scores at 2 weeks (p = 0.012). The PSAQ scores showed that patients who received NOTES-N were significantly more satisfied with their cosmetic results than those who had LN. No significant differences were seen between the 2 groups in 8 domains of SF-36 at 4, 8 and 12 mo postoperatively. There were no statistically significant differences in sexual function from preoperatively to 4 and 8 mo postoperatively or between NOTES-N and LN groups. The most significant limitation of this study is the lack of randomization. CONCLUSIONS This study adds to the existing evidence that NOTES-N is a feasible and safe surgical technique with significantly less pain, shorter LOS, shortened convalescence times, and better cosmetic result compared to LN; however, randomized trials are required to confirm benefits. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e264 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Zou xiaofeng More articles by this author Zhang guoxi More articles by this author Xue yijun More articles by this author Yuan yuanhu More articles by this author Xiao rihai More articles by this author Wu gengqing More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...