Transurethral ureteral orifice resection versus open resection after retroperitoneal laparoscopic nephroureterectomy for upper urinary urothelial carcinoma: a clinical control study of 59 cases

Abstract

Objective To evaluate the safety and effectiveness of retroperitoneal laparoscopic nephroureterectomy combined with transurethral resection of the ureteral orifice for the treatment of upper urinary urothelial carcinoma (UTUC). Methods We retrospectively analyzed the clinical data of 59 UTUC cases treated in our hospital from July 2013 to July 2019, who underwent retroperitoneal laparoscopic nephroureterectomy combined with transurethral resection of the ureteral orifice (n=20) or abdominal incision(n=39). Blood loss volume, time of incision drainage, recovery time of postoperative intestinal function, postoperative hospitalization time, postoperative complications and local recurrence, and distant metastasis were compared between the 2 groups. Results The transurethral resection group had significantly longer operative time (219.1±54.2 vs 178.7±60.8 min, P < 0.05), but shorter time of incision drainage, recovery time of postoperative intestinal function and postoperative hospitalization time (P < 0.05) when compared with the abdominal incision group. There were 4 cases having operative complications in the abdominal incision group, including 2 cases of pulmonary infection, 1 case of retroperitoneal effusion, and 1 case of lymphorrhagia. In the transurethral resection group, there was 1 case of postoperative bladder bleeding, and cystoscopic electrocision was performed for hemostasis. No significant differences were found in other evaluated indicators between the 2 groups. Conclusion Retroperitoneal laparoscopic nephroureterectomy combined with resection of the ureteral orifice is safe and effective for the treatment of UTUC. Compared with abdominal incision, transurethral approach has the advantage of less trauma and rapider recovery.

Keywords

• retroperitoneal laparoscopy
• transurethral resection of the ureteral orifice
• renal pelvis carcinoma
• ureteral carcinoma