Journal article
Importance of cosmesis to patients undergoing renal surgery: a comparison of laparoendoscopic single-site (LESS), laparoscopic and open surgery
BJU international, Vol.110(2), pp.268-272
07/01/2012
DOI: 10.1111/j.1464-410X.2011.10784.x
PMID: 22177193
Abstract
OBJECTIVE
To evaluate patient attitudes towards cosmesis relative to other considerations, before and after undergoing laparoendoscopic single-site surgery (LESS) vs laparoscopic/robot-assisted vs open kidney surgery.
METHODS
Participants were provided with a survey querying demographic information, surgical history and importance of scarring relative to other surgical outcomes and considerations.
The relative importance of each outcome was recorded on a nine-level ranking scale, ranging from 1 (most important) to 9 (least important).
The median scores for each outcome were compared before and after surgery using the Wilcoxon signed-rank test, and by surgical approach using the Kruskal Wallis test.
The importance of scarring was further analysed according to age (<= 50 vs >50 years), surgical indication (oncological vs non-oncological), gender, and proportion of patients who had undergone previous abdominal surgery.
RESULTS
A total of 90 patients completed surveys before surgery, of whom 65 (72.2%) also completed surveys after surgery.
'Surgeon reputation' and 'no complications' were the most important considerations before surgery (median scores 2 and 3, respectively) and after surgery (median scores of 2 for both).
'Size/number of scars' was the least important consideration before surgery (median score 8) and the second least important consideration after surgery (median score 7).
The median score for 'size/number of scars' was significantly higher for the LESS cohort before surgery (laparoscopic/robot-assisted vs LESS vs open surgery: 8.5 vs 6 vs 9; P = 0.003), but was nonsignificant after surgery (laparoscopic/robotic vs LESS vs open surgery: 7 vs 6.5 vs 7.5; P = 0.83).
The median score for 'size/number of scars' before surgery was significantly higher for younger patients (P = 0.05) and those with non-oncological surgical indications (P < 0.001), but there was no significant difference in this outcome for these sub-groups after surgery.
CONCLUSIONS
For most patients contemplating urological surgery, cosmesis is of less concern than surgeon reputation and avoidance of surgical complications.
Cosmesis may be a more important preoperative consideration for younger patients and those with benign conditions, which warrants further investigation.
Details
- Title: Subtitle
- Importance of cosmesis to patients undergoing renal surgery: a comparison of laparoendoscopic single-site (LESS), laparoscopic and open surgery
- Creators
- Ephrem O. Olweny - The University of Texas Southwestern Medical CenterSaad A. Mir - The University of Texas Southwestern Medical CenterSara L. Best - The University of Texas Southwestern Medical CenterSamuel K. Park - The University of Texas Southwestern Medical CenterChester Donnally - The University of Texas Southwestern Medical CenterJeffrey A. Cadeddu - The University of Texas Southwestern Medical CenterChad R. Tracy - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- BJU international, Vol.110(2), pp.268-272
- Publisher
- Wiley
- DOI
- 10.1111/j.1464-410X.2011.10784.x
- PMID
- 22177193
- ISSN
- 1464-4096
- eISSN
- 1464-410X
- Number of pages
- 5
- Language
- English
- Date published
- 07/01/2012
- Academic Unit
- Radiology; Urology
- Record Identifier
- 9984318724902771
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