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

ABSTRACT

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.