Long term outcomes of laparoscopic and open modified lich-gregoir reimplantation in adults: a multicentric comparative study

Background and Objective: Obstructive ureteral pathologies in adult patients are most commonly due to ureteral strictures and secondary to surgical interventions. In this study, we aimed to compare open and iaparoscopic modified Lich-Gregoir ureteral reimplantation with regards to outcomes in benign ureteral pathologies in adult patients

Methods: Between December 2008 and December 2014, 32 open cases and 29 laparoscopic cases were performed as per the data retrieved from surgical databases. All laparoscopic procedures were performed in Bakirkoy Dr. Sadi Konuk Training and Research Hospital [BEAH] and all open ureteral reimplantation procedures in Kartal Dr Lutfi Kirdar Training and Research Hospital [KEAH] and Okmeydani Training and Research Hospital [OEAH]

Results: The mean operation time was significantly lower in the group of patients operated with open group [142.5 minutes versus 188.9 minutes; P< 0.0001]. The mean duration of follow-up was longer in the laparoscopy group [31 versus 28 months; p< 0.0001]. The mean amount of operation associated blood loss was significantly lower in patients operated laparoscopically [93.7 ml versus 214 ml; P< 0.0001]. The mean VAS score obtained six hours after surgery was 6.6 +/- 0.8 in open group, and 5.8 +/- 0.7 in laparoscopic group [p=0.0004]. The mean VAS scores measured at post-operative day 1 was 4.5 +/- 0.7 in open group and 3.7 +/-0.9 in laparoscopy group. Time required to achieve the pre-operative capability of daily activities was significantly longer in open group [15 +/- 1.4 days vs 11 +/- 1.4 days; p< 0.0001]

Conclusion: Despite open techniques provide shorter operation time and laparoscopic techniques require long learning curve, we think that laparoscopic techniques are superior to open ones since that they provide a better post-operative comfort and are better tolerated in terms of complications

Metastasis of Non-Muscle-Invasive Bladder Cancer Into the Thyroid Gland: A Literature Review Accompanied by a Rare Case

Bladder cancer is the most prevalent malignancy of the urinary tract. About 90% of bladder cancers are urothelial carcinomas. Seventy percent of cases newly diagnosed are superficial diseases; roughly 30% of newly diagnosed cases are muscle-invasive metastatic diseases. Bladder urothelial carcinoma primarily metastasizes into regional lymph nodes and then into liver, lung, mediastinum, bone, and adrenal gland. In our case, non-muscle-invasive bladder cancer metastasized into the bone, mediastinum, iliac lymph node, and adrenal and thyroid glands. This is the first reported case in the current literature in which urothelial carcinoma metastasized into the thyroid gland.