Endoscopic Ureteral Procedures for One-Step Nephroureterectomy: Experience in 100 Cases

Geavlete, P.; Georgescu, D.; Bancu, S; Mirciulescu, V.

doi:10.1089/end.2006.0426

Cited by 20 publications

(10 citation statements)

References 24 publications

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“…Geavlete et al reported that two out of 28 patients had un-successful stripping, necessitating open surgery. The disease-specific mortality rate of the pluck technique in combination with the stripping technique was 12%, and no significant difference was observed regarding operative time, complications and oncologic outcome (7). Giovansili et al stated that the stripping technique in open nephroureterectomy is a simple and safe procedure (8).…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal approach for laparoscopic nephroureterectomy with stripping technique: Extracorporeal ligation of ureter and ureteral catheter

Nakamura

Nagata

Kajikawa

et al. 2012

Asian J Endoscop Surgery

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Section: Discussionmentioning

confidence: 99%

Retroperitoneal approach for laparoscopic nephroureterectomy with stripping technique: Extracorporeal ligation of ureter and ureteral catheter

Nakamura

Nagata

Kajikawa

et al. 2012

Asian J Endoscop Surgery

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“…Several modifications of this procedure have been described. [ 29 30 31 ] In general, a bulb-tipped ureteral catheter is placed endoscopically at the beginning of the procedure, nephrectomy is then performed, the ureter is dissected downward to the bladder, ligatures are placed above and below the bulb so that the catheter is well-secured and afterward the ureter is divided above the catheter. Afterward, the patient is moved to the lithotomy position and the ureter is intussuscepted into the bladder with retrograde traction on the ureteric catheter, while a resectoscope is passed alongside the inverted ureter to excise the attached orifice.…”

Section: Distal Ureterectomy Techniquesmentioning

confidence: 99%

Distal ureterectomy techniques in laparoscopic and robot-assisted nephroureterectomy: Updated review

et al. 2015

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Controversies exist about the best method for managing the distal ureter during the laparoscopic (LNU) and robot-assisted nephroureterectomy (RANU). Therefore, PubMed, Scopus and Web of Science databases were searched in order to identify articles describing the management of distal ureter during LNU or RANU in patients suffering from upper urinary tract urothelial cell carcinoma. Forty seven articles were selected for their relevance to the subject of this review. The approaches that are usually performed regarding the distal ureter management are open excision, transurethral resection of ureteral orifice (Pluck Technique), ureteric intussusception and pure LNU or pure RANU. Pure LNU and RANU with complete laparoscopic dissection and suture reconstruction of ureter and bladder cuff seems to be better tolerated than open nephroureterectomy providing equal efficacy, without deteriorating the oncological outcome, however evidence is poor. Transurethral resection of the ureteric orifice and the bladder cuff after occlusion of the ureter with a balloon catheter seems to be an attractive alternative option for low stage, low grade tumors of the renal pelvis and the proximal ureter, while stapling technique is correlated with the increased risk of positive surgical margins. The open resection of the distal ureter in continuity with the bladder cuff is considered the most reliable approach, preferred in our practice as well, however the existing data are based on retrospective and non-randomized studies.

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“…The technique failed to complete in only 1 of 577 cases (0.2%) where periureteral fibrosis necessitated conversion to an open procedure [18] . Only 8 of 508 patients (2%) developed complications related to cystoscopic detachment: haematuria (1), retroperitoneal extravasation requiring prolonged drainage (3), urinary retention (3) and urinary tract infection (1) [9,13,49] . The final pathology showed highgrade TCC in 39% and muscle-invasive TCC in 40%.…”

Section: Cystoscopic Detachment Of the Ureter By Transurethral Resectmentioning

confidence: 99%

“…Ten articles included 169 patients treated by the ureteric stripping technique [9,17,19,20,31,34,36,37,41,43] . Of 169 procedures performed for UUT-TCC, two thirds were selected patients where the tumour was not located in the distal ureter.…”

Section: Ureteric Stripping Techniquementioning

confidence: 99%

Management of the Distal Ureter during Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma: A Review

2010

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Introduction: The standard treatment for upper urinary tract transitional cell carcinoma (UUT-TCC) is open radical nephroureterectomy with excision of a bladder cuff. We assess the successful endoscopic completion and oncological efficacy of the various minimally invasive transurethral techniques devised for the management of the intramural ureter during nephroureterectomy. Materials and Methods: A comprehensive review of the English literature until February 2009 using the PubMed database returned 42 relevant papers. Five methods of endoscopic management of the distal ureter were identified and compared to the open technique. Results: There are no randomised studies. Successful completion of the endoscopic procedure was less (91%) for the ureteric stripping technique than for the other endoscopic modalities (99.8–100%). Recurrences were highest for laparoscopic extravesical ureteric stapling in conjunction with cystoscopic detachment of the ureter, although the numbers analysed were small. For the other endoscopic modalities, bladder recurrence, positive margins and retroperitoneal recurrence (20–37, 0–4 and 1–3%, respectively) in case series were similar compared with the open method (36, 5 and 3%, respectively). Conclusions: Current non-randomised evidence is open to selection bias and is insufficient to support or refute endoscopic management of the distal ureter as an alternative to open bladder cuff excision. We highlight the reported inefficiency of the ureteric stripping technique.

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Endoscopic Ureteral Procedures for One-Step Nephroureterectomy: Experience in 100 Cases

Abstract: The endoscopic approach to the terminal ureter is safe and effective as part of one-step nephroureterectomy. Differences between the techniques with regard to operative time, complications, and oncologic outcome were not significant.

Cited by 20 publications

References 24 publications

Retroperitoneal approach for laparoscopic nephroureterectomy with stripping technique: Extracorporeal ligation of ureter and ureteral catheter

Retroperitoneal approach for laparoscopic nephroureterectomy with stripping technique: Extracorporeal ligation of ureter and ureteral catheter

Distal ureterectomy techniques in laparoscopic and robot-assisted nephroureterectomy: Updated review

Management of the Distal Ureter during Nephroureterectomy for Upper Urinary Tract Transitional Cell Carcinoma: A Review

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