Journal article
Patient-Reported Body Image and Cosmesis Outcomes Following Kidney Surgery: Comparison of Laparoendoscopic Single-Site, Laparoscopic, and Open Surgery
European urology, Vol.60(5), pp.1097-1104
11/2011
DOI: 10.1016/j.eururo.2011.08.007
PMID: 21856076
Abstract
Laparoendoscopic single-site surgery (LESS) is reported to result in superior cosmesis versus alternative surgical approaches, based solely on surgeon assessment or anecdotal evidence.
Evaluate patient-reported body image and cosmesis outcomes following kidney surgery.
We conducted a prospective and retrospective observational cohort study involving patients who underwent kidney surgery (n=114) via LESS (n=35), laparoscopic (n=52), or open (n=27) approaches. Cosmesis was evaluated using a comprehensive survey administered ≥3 mo postoperatively.
Survey components were a body image questionnaire (BIQ) consisting of body image and cosmesis subscales, a photo-series questionnaire (PSQ) assessing scar preferences after knowledge of scar outcomes for alternative surgical approaches, and query of preference for future surgical approach using a trade-off method. Body image, cosmesis, and PSQ scales ranged from 5 to 20, 3 to 24, and 1 to 10, respectively.
Median BIQ component scores did not significantly differ across surgical approaches. Median ratings for the LESS, laparoscopy, and open scar photographs were 8, 5, and 5, respectively (p=0.0001). Before viewing photographs, median self-scar ratings for LESS, laparoscopy, and open approaches were 9, 5, and 6.5, respectively (p=0.02); after photographs, ratings were 9, 7, and 7, respectively (p=0.008). Assuming equivalent surgical risk among the approaches, overall preference for future LESS, laparoscopy, or open surgery was 39%, 33%, or 4%, respectively. As theoretical risk of LESS was raised, preference for LESS decreased, whereas preference for laparoscopy and open surgery increased. Study limitations are a nonrandomized design and the use of a nonvalidated scale.
Urologic patients favor LESS cosmesis outcomes over those for laparoscopy or open surgery. Considering the superior scar satisfaction among LESS patients, who were younger and more likely to be undergoing surgery for benign disease, we infer that this demographic most values the cosmetic advantages of LESS.
Urologic patients value the cosmetic outcomes of laparoendoscopic single-site surgery (LESS). With further development, improving on safety and technique, LESS should be offered as an acceptable surgical approach to appropriately selected and willing patients.
Details
- Title: Subtitle
- Patient-Reported Body Image and Cosmesis Outcomes Following Kidney Surgery: Comparison of Laparoendoscopic Single-Site, Laparoscopic, and Open Surgery
- Creators
- Samuel K Park - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USAEphrem O Olweny - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USASara L Best - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USAChad R Tracy - Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, USASaad A Mir - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USAJeffrey A Cadeddu - Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Resource Type
- Journal article
- Publication Details
- European urology, Vol.60(5), pp.1097-1104
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.eururo.2011.08.007
- PMID
- 21856076
- ISSN
- 0302-2838
- eISSN
- 1873-7560
- Language
- English
- Date published
- 11/2011
- Academic Unit
- Radiology; Urology
- Record Identifier
- 9984051763602771
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