[Comparison of natural orifice transumbilical endoscopic surgery versus conventional laparoscopic surgery in renal cyst deroofing].

ABSTRACT

OBJECTIVE: To compare the safety and feasibility of natural orifice transumbilical endoscopic surgery (NOTES) versus conventional laparoscopic surgery in renal cyst deroofing. METHODS: From May 2010 to August 2011, 8 cases of renal cysts underwent cyst deroofing by the technique of NOTES (Triport) (group A) and 14 cases by conventional laparoscopic surgery (Group B) respectively. The data of patient age, cyst size, operative duration, estimated blood loss, intra-operative complications, drainage duration, post-operative pain score (VAPS) and post-operative hospital stay were recorded and analyzed. RESULTS: The average cyst sizes of groups A and B were 6.6 ± 2.4 and 7.0 ± 2.5 cm. There was no conversion to open surgery in neither groups and no conversion to standard laparoscopic surgery in group A. The operative duration, estimated blood volume, VAPS and post-operative hospital stay of both groups were 49 vs 35 min, 12 vs 10 ml, 0 vs 1 and 4 vs 5 days respectively. The drainage duration was 1 day for both groups. No severe complication, secondary hemorrhage or wound infection occurred in neither groups. As judged by both surgeons and patients, the post-operative cosmetic appearances of group A were better than those of group B. CONCLUSION: The cyst deroofing by NOTES is a safe and feasible option for the treatment of renal cysts. As compared with conventional laparoscopic surgery, NOTES may achieve better cosmetic effects with smaller wounds.