Korean J Urol.  2007 Apr;48(4):371-375. 10.4111/kju.2007.48.4.371.

Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma: A Comparison with Open Nephroureterectomy

Affiliations
  • 1Department of Urology, College of Medicine, Kyungpook National University, Daegu, Korea. tgkwon@knu.ac.kr

Abstract

PURPOSE
Laparoscopic nephroureterectomy (LNUx) has recently been done to treat patients with upper tract transitional cell carcinoma. We retrospectively evaluated the efficacy and safety of LNUx in comparison with open nephroureterectomy (ONUx).
MATERIALS AND METHODS
Between May 2001 and March 2006, a total of 51 patients underwent radical nephroureterectomy for upper tract transitional cell carcinoma, including 22 LNUx and 29 ONUx. LNUx was performed transperitoneally and the ureteral end with a bladder cuff was transected through a 5-7cm modified Gibson incision. All the specimens were extracted intact. The patients' characteristics and the perioperative and followup data were analyzed retrospectively.
RESULTS
LNUx was successfully performed in all the patients without open conversion. The analgesic requirement was lower, and the average time to oral intake and the length of hospitalization were shorter for LNUx than for ONUx. The average operative time, estimated blood loss and complications were not statistically different between the LNUx and ONUx. The mean follow-up periods of the LNUx and ONUx were 13.7 and 30.0 months, respectively. Both groups were similar in regard to bladder recurrence, local recurrence and distant metastasis. There was no sign of the trocar site or peritoneal seeding after LNUx.
CONCLUSIONS
Our results suggest that LNUx is an acceptable alternative to ONUx for treating upper urinary tract transitional cell carcinoma. However, a longer follow-up period and comparative studies to the standard open techniques will be required.

Keyword

Carcinoma, transitional cell; Laparoscopic surgery; Nephrectomy

MeSH Terms

Carcinoma, Transitional Cell*
Follow-Up Studies
Hospitalization
Humans
Laparoscopy
Neoplasm Metastasis
Nephrectomy
Operative Time
Recurrence
Retrospective Studies
Surgical Instruments
Ureter
Urinary Bladder
Urinary Tract*
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