The Early Experience of Retroperitoneoscopic Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinomas / 대한비뇨기과학회지

PURPOSE: Retroperitoneoscopic nephroureterectomy (RNUx), with a bladder cuff excision, has only recently been used to treat patients with upper tract transitional cell carcinomas. We retrospectively evaluated our early experiences, and compared our results to those of a contemporary series of open nephroureterectomies (ONUx), in upper tract transitional cell carcinomas. MATERIALS AND METHODS: We reviewed the records of 7 patients who had undergone a RNUx, with a bladder cuff excision, for a suspicious upper tract transitional cell carcinoma, and 7 who had undergone an ONUx, with a bladder cuff excision. RESULTS: Comparing the results of the RNUx (7 patients) to the ONUx (7 patients) over the same period, we found no significant differences in the body mass index (25.1 versus 25.5kg/m2, p=0.22), specimen weights (155 versus 175gm, p=0.59) and operating time (266 versus 244 min., p=0.20). The RNUx group had significantly reduced estimated blood losses (350 versus 543mL, p=0.01), pain medication requirements (141 versus 232mg, p=0.03) and times to ambulate (21 versus 31 hours, p<0.01). CONCLUSIONS: Our early experiences show that RNUx takes a longer operation time, and is a harder operation compared to ONUx, but it is well tolerated by patients because we can remove the kidney and ureter from a smaller lower abdominal incision. With increased experience, the operating time decreased compared to an ONUx. Thus, a RNUx may be a viable alternative for managing localized transitional cell carcinomas of the upper urinary tract.

The Early Experience of Retroperitoneoscopic Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinomas / 대한비뇨기과학회지

PURPOSE: Retroperitoneoscopic nephroureterectomy (RNUx), with a bladder cuff excision, has only recently been used to treat patients with upper tract transitional cell carcinomas. We retrospectively evaluated our early experiences, and compared our results to those of a contemporary series of open nephroureterectomies (ONUx), in upper tract transitional cell carcinomas. MATERIALS AND METHODS: We reviewed the records of 7 patients who had undergone a RNUx, with a bladder cuff excision, for a suspicious upper tract transitional cell carcinoma, and 7 who had undergone an ONUx, with a bladder cuff excision. RESULTS: Comparing the results of the RNUx (7 patients) to the ONUx (7 patients) over the same period, we found no significant differences in the body mass index (25.1 versus 25.5kg/m2, p=0.22), specimen weights (155 versus 175gm, p=0.59) and operating time (266 versus 244 min., p=0.20). The RNUx group had significantly reduced estimated blood losses (350 versus 543mL, p=0.01), pain medication requirements (141 versus 232mg, p=0.03) and times to ambulate (21 versus 31 hours, p<0.01). CONCLUSIONS: Our early experiences show that RNUx takes a longer operation time, and is a harder operation compared to ONUx, but it is well tolerated by patients because we can remove the kidney and ureter from a smaller lower abdominal incision. With increased experience, the operating time decreased compared to an ONUx. Thus, a RNUx may be a viable alternative for managing localized transitional cell carcinomas of the upper urinary tract.

A Fistula between Ileal Conduit and Iliac Artery after Radical Cystectomy with Ileal Conduit Urinary Diversion / 대한비뇨기과학회지

A radical cystectomy, including a pelvic lymphadenectomy, is a standard treatment for a muscle invasive bladder tumor, but it is considered a major operation, with serious complications, and most complications develop in the early postoperative period. After a radical cystectomy, with ileal conduit urinary diversion (ICUD), bleeding is a common and well known complication in the early postoperative period, but rare in the later period. Here we report a case of massive bleeding from an ileal conduit 3 months after a radical cystectomy, with ICUD, due to a rupture of the iliac artery pseudoaneurysm, which was treated by vascular suture of the right iliac artery.

Perforated Appendicitis Presenting as a Bladder Tumor in a 3 Year-Old Girl / 대한비뇨기과학회지

Large bladder masses in children are extremely rare pathological lesions. They can present as a gross hematuria, with irritable or obstructive voiding symptoms and a urinary tract infection. Their differential diagnosis must include for genitourinary malignancies, such as rhabdomyosarcoma, as well as benign inflammatory lesions. A case of a bladder mass in a three-year-old girl is reported, which was finally diagnosed as localized perforated appendicitis.

Epithelioid Angiomyolipoma of the Kidney with Distant Metastasis / 대한비뇨기과학회지

An epithelioid angiomyolipoma is an uncommon clinicopathological variant of an angiomyolipoma. A 25-year-old man presented with a huge right renal tumor and underwent a radical nephrectomy. The pathological diagnosis was an epithelioid angiomyolipoma, which showed a positive reaction to the HMB-45 monoclonal antibody and negative to epithelial cell markers. A year later, multiple metastases developed to the liver, lungs and bones. A hepatic lobectomy was performed, and a metastatic epithelioid angiomyolipoma, from the original renal tumor, was pathologically confirmed. The case is presented with a review of the literature.