Endoscopic versus open approach of bladder cuff and distal ureter in the management of upper urinary tract transitional cell carcinoma.
نویسندگان
چکیده
OBJECTIVE Nephroureterectomy with the removal of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment for upper urinary tract urothelial cancer. The distal ureter can be removed with the open surgical technique or endoscopic approach. We compared the outcomes of the endoscopic approach with those of conventional open surgery on the distal ureter. MATERIALS AND METHODS We collected data from the charts of 30 patients who underwent radical nephroureterectomy at our clinic from January 1997 to January 2007 for upper urinary tract urothelial carcinoma. The patients were divided into two groups according to procedure performed on the distal ureter. Group I (n:12) was comprised of patients who underwent an open surgical procedure, and group II (n:18), was comprised of patients who underwent an endoscopic approach. Both groups were compared in terms of operative time, blood loss, transurethral catheter duration and duration of hospital stay. RESULTS Patient age and tumor location showed no significant differences between the two groups. The operative time was significantly longer in group I than group II (181 versus 128 minutes; p<0.05). On the other hand, the estimated blood loss, transurethral catheter duration and duration of hospital stay were significantly lower in group II (205 mL versus 435 mL, 5 versus 8.5 days and 5.6 versus 9.2 days, respectively; p <0.05). CONCLUSION The results of our study show that the endoscopic approach is less invasive than open surgery on the distal ureter. This procedure can easily be performed in the management of upper urinary tract urothelial carcinoma.
منابع مشابه
Management of the distal ureter during nephroureterectomy for upper urinary tract transitional cell carcinoma: a review.
INTRODUCTION The standard treatment for upper urinary tract transitional cell carcinoma (UUT-TCC) is open radical nephroureterectomy with excision of a bladder cuff. We assess the successful endoscopic completion and oncological efficacy of the various minimally invasive transurethral techniques devised for the management of the intramural ureter during nephroureterectomy. MATERIALS AND METHO...
متن کاملManagement of the Distal Ureter during Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma: A Review
Introduction: The standard treatment for upper urinary tract transitional cell carcinoma (UUT-TCC) is open radical nephroureterectomy with excision of a bladder cuff. We assess the successful endoscopic completion and oncological efficacy of the various minimally invasive transurethral techniques devised for the management of the intramural ureter during nephroureterectomy. Materials and Method...
متن کاملManagement of the Distal Ureter during Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma: A Review
Introduction: The standard treatment for upper urinary tract transitional cell carcinoma (UUT-TCC) is open radical nephroureterectomy with excision of a bladder cuff. We assess the successful endoscopic completion and oncological efficacy of the various minimally invasive transurethral techniques devised for the management of the intramural ureter during nephroureterectomy. Materials and Method...
متن کاملTransurethral resection versus open bladder cuff excision in patients undergoing nephroureterectomy for upper urinary tract carcinoma: Operative and oncological results
OBJECTIVES To evaluate the impact of distal ureter management on oncological results after open nephroureterectomy (ONU) comparing transurethral resection of the intramural ureter to conventional open excision, as controversy still exists about the method of choice for managing the distal ureter and bladder cuff during ONU. PATIENTS AND METHODS We retrospectively collected data from 378 patie...
متن کاملComprehensive Management of Upper Tract Urothelial Carcinoma
Urothelial carcinoma of the upper urinary tract represents only 5% of all urothelial cancers. The 5-year cancer-specific survival in the United States is roughly 75% with grade and stage being the most powerful predictors of survival. Nephroureterectomy with excision of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment of the upper urinary tract uroth...
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ورودعنوان ژورنال:
- The Eurasian journal of medicine
دوره 40 3 شماره
صفحات -
تاریخ انتشار 2008