Initial Experience of Retroperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma

Kim, Dong Woo; Ryu, Dong Soo; Oh, Tae Hee

Abstract

PURPOSE: We report our experience of retroperitoneal laparoscopic nephroureterectomy (RLNUx) in 10 consecutive patients with an upper tract transitional cell carcinoma, and compare the results to those of a contemporary group of patients who underwent an open nephroureterectomy (ONUx).
MATERIALS AND METHODS
The records of 10 and 17 patients who underwent RLNUx and ONUx, respectively, for an upper urinary tract transitional cell carcinoma between February 1988 and February 2004, were reviewed.
RESULTS
The RLNUx, for the upper urinary tract transitional cell carcinoma, was successfully performed in all patients. Patients who underwent RLNUx had significantly less blood loss (308 versus 626.4cc, p=0.002) and consumption of ketorolac tromethamine for postoperative pain control (128.5 versus 215mg, p=0.001). However, there were no significant differences between the RLNUx and ONUx regarding the mean operative time (250 versus 222.6 minutes, p=0.081), interval to resuming oral intake (1.7 versus 1.8 days, p=0.530) and hospital stay (9.3 versus 9.8 days, p=0.300). Atelectasis and postoperative bleeding occurred in 1 RLNUx patient and atelectasis occurred in 3 ONUx patients. During average follow-ups of 19 and 25.9 months, for the RLNUx and ONUx, respectively, 1 and 2 patients had lymph node metastasis. Two patients with concomitant bladder tumors who had undergone transurethral resection at the time of the RLNUx, and two who had undergone ONUx had recurrent transitional cell carcinoma of the bladder.
CONCLUSIONS
Based on our experience, we believe that RLNUx is a feasible treatment option for patients with an upper tract transitional cell carcinoma. However, long-term follow-up is necessary to confirm the efficacy for patients with transitional cell carcinomas of the renal pelvis and ureter.