Application of transurethral bipolar plasma kinetic vaporization in radical nephroureterectomy / 中国微创外科杂志

ABSTRACT

Objective To study the application of transurethral bipolar plasma kinetic vaporization of the distal ureterectomy in radical nephroureterectomy for renal pelvic or ureteral carcinoma. Methods A total of 6 patients with renal pelvic or ureteral carcinoma without involvement in ipsilateral distal ureter,ureteral orfice,and the bladder were included.Radical nephroureterectomy was performed by using transurethral bipolar plasma kinetic vaporization combined with either flank incision nephrectomy (5 patients) or retroperitoneal approach laparoscopic nephrectomy(1 patient). Results The operation was completed smoothly in the 6 patients with comparatively little blood loss.The operation time was 120~210 min(mean,150 min).Obturator nerve reflex happened in no patients during the operation.Postoperative bladder irrigation found no bleeding in the bladder.The time of indwelling the catheter was 7~9 d(mean,8 d).Hypogastralgia and fever occurred in 1 patient on the 5th postoperative day.And the patient was confirmed as having mild urinary extravasation and was given catheter indwelling for 5 days. Transuretheral cystography found no leakage and a full recovery of voiding function was achieved.Postoperative pathological findings showed negative margins in all the patients.One patient died of myocardial infarction 3 months after operation,while follow-up in the remaining 5 patients for 7~21 months(mean,16 months) showed no tumor recurrence. Conclusions Application of transurethral bipolar plasma kinetic vaporization of the distal ureterectomy is micro-invasive,with little hemorrhage and few complications.It is an effective assistant option in radical nephroureterectomy.