Critical Considerations regarding Laparoscopic Nephroureterectomy for the Treatment of Upper Urinary Tract Carcinoma

Objectives: To review the pro and con arguments for a laparoscopic approach for the treatment of upper urinary tract cancer. Methods: Fourteen series comparing open nephroureterectomy (NUT) with laparoscopic NUT have been studied with regards to cancer control and related morbidity. Results: Event though the open approach is still the gold standard treatment, the laparoscopic approach has shown its applicability with a favourable safety profile while providing good oncologic outcome. In comparative as well as noncomparative series, results were comparable for the development of local recurrences (4% vs. 6%) and distant metastases (15.5% vs. 15.1%), and patient’s long-term survival (2-yr survival: 75% vs. 76%) following laparoscopic and open NUT, respectively. However, certain types of laparoscopic bladder cuff control led to insufficient prevention of bladder recurrences. Conclusions: Laparoscopic NUT provides an oncologic outcome comparable to open surgery when performed in patients with early-stage diseases. # 2007 Published by Elsevier B.V. on behalf of European Association of Urology.