462 Patient-reported satisfaction and cosmesis outcomes following laparoscopic adrenalectomy: LESS vs conventional laparoscopic surgery

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  • Inoue S., Ikeda K., Hieda K., Shoji K., Miyamoto K., Ohara S., Kobayashi K., Kajiwara M., Teishima J., Matsubara A.

    Hiroshima University, Dept. Of Urology, Hiroshima, Japan

    INTRODUCTION & OBJECTIVES: Laparoendoscopic single site surgery (LESS) continues to gain prevalence in

    urology, with reported equivalent perioperative outcomes and superior cosmesis to conventional laparoscopic surgery

    (CLS). The purpose of this study was to evaluate patient-reported satisfaction and cosmesis of LESS in comparison

    with that of CLS in Japanese.

    MATERIAL & METHODS: A total of 19 and 104 patients who underwent LESS and CLS between May 1996 and June

    2011 were included in the study. Questionnaires inquiring about scar pain (0: not painful, 10: very painful), satisfaction

    (0: not satisfied, 10: very satisfied), and cosmesis (0: very ugly, 10: very beautiful) on the basis of a visual analogue

    scale that was sent to patients postoperatively.

    RESULTS: Eleven (4 men and 7 women) and 52 (24 men and 28 women) patients who underwent LESS and CLS,

    respectively, responded. The mean follow-up times after surgery were 64.9 (range 18-181) and 11.4 (range 5-19)

    months for the CLS and LESS groups, respectively (p < 0.001). There was no significant inter-group difference in age,

    male-to-female ratio, affected side, BMI, and blood loss. Insufflation time was significantly longer in the LESS group

    than the conventional group (229 vs. 177 min, p = 0.041). Results of patient-reported cosmesis outcomes stratified by

    operative approach are shown in Table #1. There was no significant difference in pain (p = 0.393), satisfaction (p =

    0.453), and cosmesis score (p = 0.487). In female patients, satisfaction score was significantly higher in the LESS

    group than the conventional group (p = 0.049).

    462 Patient-reported satisfaction and cosmesis outcomes following laparoscopic adrenalectomy: LESS vs conventional laparoscopic surgery

    Eur Urol Suppl 2013;12;e462

    LESS CLS p-value

    Pain score

    Total 0.672.31 0.571.74 0.393

    Male 1.143.02 0.040.20 0.122

    Female 0.000.00 1.032.29 0.122

    Satisfaction score

    Total 8.921.73 8.462.24 0.453

    Male 8.141.95 8.162.58 0.717

    Female 10.00.00 8.721.91 0.049

    Cosmesis score

    Total 8.581.93 8.002.47 0.487

    Male 7.862.27 7.602.84 0.620

    Female 9.600.55 8.342.09 0.202

  • CONCLUSIONS: No significant difference was obtained in patient-reported satisfaction and cosmesis following LESS

    and CLS. However, female patients satisfy LESS scar outcomes over those for CLS. Further evaluation is needed by

    longitudinal study to clarify whether LESS is superior to CLS in terms of satisfaction and cosmesis.

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