Laparoscopic versus open nephroureterectomy to treat localized and/or locally advanced upper tract urothelial carcinoma: oncological outcomes from a multicenter study

Liu, Jian Ye; Dai, Ying; Zhou, Fang; Li, Zhi; Li, Yong Hong; Xie, Dan; Liu, Bin; Tang, Jin; Tan, Jianxin; Yao, Kun; He, Lan

doi:10.1186/s12893-016-0202-x

Cited by 19 publications

(13 citation statements)

References 30 publications

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“…Considerable efforts have been made to ensure the oncological outcomes equivalence between LNU and RANU. 5,7,14,15 No differences were noted in most studies, except in one meta-analysis that suggested a superiority of ONU for patients with locally advanced high-risk (pT3/ pT4 and/or high-grade) UTUC. 5 In consequence, MINU might represent an adequate alternative to ONU.…”

Section: Discussionmentioning

confidence: 98%

“…Minimally invasive surgery is currently widely used in urological oncology. Considerable efforts have been made to ensure the oncological outcomes equivalence between LNU and RANU . No differences were noted in most studies, except in one meta‐analysis that suggested a superiority of ONU for patients with locally advanced high‐risk (pT3/pT4 and/or high‐grade) UTUC .…”

Section: Discussionmentioning

confidence: 99%

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Comparison of perioperative outcomes between open and minimally invasive nephroureterectomy: A population‐based analysis

et al. 2019

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Objectives To examine intraoperative and postoperative morbidity and mortality, as well as the impact on length of stay and total hospital charges of minimally invasive nephroureterectomy compared with open nephroureterectomy in patients with upper tract urothelial carcinoma. Methods Within the National Inpatient Sample (2008–2013), we identified patients with non‐metastatic upper tract urothelial carcinoma treated with either minimally invasive nephroureterectomy or open nephroureterectomy. We relied on inverse probability of treatment weighting to reduce the effect of inherent differences between open nephroureterectomy versus minimally invasive nephroureterectomy. Multivariable logistic regression, multivariable Poisson regression models and multivariable linear regression models were used. Results Between 2008 and 2013, we identified 3897 patients treated with either minimally invasive nephroureterectomy (1093 [28%]) or open nephroureterectomy (2804 [72%]). In multivariable logistic regression models, minimally invasive nephroureterectomy resulted in lower rates of overall (odds ratio 0.71, P < 0.001), wound (odds ratio 0.49, P = 0.01), intraoperative (odds ratio 0.55, P = 0.01), miscellaneous surgical (odds ratio 0.64, P = 0.008) and miscellaneous medical complications (odds ratio 0.77, P = 0.002). Furthermore, minimally invasive nephroureterectomy was associated with lower rates of transfusions (odds ratio 0.61, P < 0.001). In multivariable Poisson regression models, minimally invasive nephroureterectomy was associated with shorter length of stay (relative risk 0.88, P < 0.001). Finally, higher total hospital charges ($2500 more per patient) were recorded for minimally invasive nephroureterectomy. Conclusions Intraoperative and postoperative morbidity, as well as length of stay, but not total hospital charges favor minimally invasive nephroureterectomy over open nephroureterectomy. These outcomes validate the safety and feasibility of minimally invasive nephroureterectomy in select upper tract urothelial carcinoma patients.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Comparison of perioperative outcomes between open and minimally invasive nephroureterectomy: A population‐based analysis

et al. 2019

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“…Failure to perform adequate lymphadenectomy does not seem to be influenced by the approach (open versus laparoscopic). In a comparative analysis of open versus laparoscopic nephroureterectomy, Liu et al found that 59.6% and 55.8% patients undergoing open and laparoscopic NU did not undergo a simultaneous lymphadenectomy respectively [21].…”

Section: Trends In Lymphadenectomymentioning

confidence: 99%

“…The main hurdle for lymphadenectomy during laparoscopy is the technical challenge associated with the procedure. There is a wide variability in the reported implementation of simultaneous lymphadenectomy during LNU (transperitoneal, retroperitoneal or hand assisted) [20,21,30]. During a minimally invasive approach, lymphadenectomy is performed predominantly for enlarged lymph nodes detected either on preoperative imaging or during surgery itself.…”

Section: Impact Of Minimally Invasive Surgery On Lymphadenectomymentioning

confidence: 99%

Current Status of Lymphadenectomy During Radical Nephroureterectomy for Upper Tract Urothelial Cancer—Yes, No or Maybe?

Tamhankar

Patil

Ahluwalia

et al. 2018

Indian J Surg Oncol

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While pelvic lymphadenectomy during radical cystectomy for bladder cancer is a well-established standard of care, the same does not hold true for upper tract urothelial carcinoma (UTUC). Indeed, a template-based lymphadenectomy is rarely, if ever, performed in conjunction with radical nephroureterectomy at most centres across the globe. While multiple studies have explored the staging and therapeutic role of lymphadenectomy in cases of UTUC, there remain large gaps in our understanding of the indications, extent and safety of this procedure as an adjunct to nephroureterectomy. This article elucidates the current knowledge on outcomes, benefits and complications of template-based lymphadenectomy during radical nephroureterectomy for UTUC. We also explore the current evidence-based guidelines on this controversial topic.

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“…With the advancement of laparoscopic techniques and the accumulation of operative experience, laparoscopic total nephroureterectomy with excision of bladder cuff have been applicable to a growing number of pelvic ureteral cancer patients in many centers since it was successfully performed by Clayman et al in 1991[5,6]. Recently, laparoscopic nephroureterectomy has replaced open surgery as standard surgical treatment for upper urinary tract epithelial carcinoma bacause of the less intraoperative bleeding, minimal invasion, quicker recovery and shorter postoperative hospital stay[7][8][9][10][11].At present there are many surgical approaches for laparoscopic nephroureterectomy. The most common method was the Bishoff method[12], that is, laparoscopic renal and upper ureter resection in the upper abdomen, and lower ureter and partial bladder incision in the lower abdomen.…”

mentioning

confidence: 99%

Clinical application of one-position complete retroperitoneal laparoscopic radical resection of renal pelvis and ureteral carcinoma

Yu¹,

Du²,

Hou³

et al. 2020

Preprint

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Background: To explore the surgical technique and the clinical efficacy of complete retroperitoneal laparoscopic radical resection in patients with upper tract urothelial carcinoma (UTUC).Methods: A total of 11 patients (6 males and 5 females) newly diagnosed with UTUC with T1/T2 were enrolled in this study who underwent one-position complete retroperitoneal laparoscopic radical resection in our hospital from March 2016 to December 2018. Among them, 8 cases were of renal pelvis carcinoma and 3 cases were of ureteral carcinoma. The average age was 57.5 years (range, 44-78 years). All patients were presented with painless gross hematuria. CTU and ureteroscopy were used to diagnose.Results All the 11 patients had successful operations without open transition. The mean operating time was 85 min (range 60 to 115 min). The mean amount of intraoperative bleeding was below 90 ml. The postoperative hospital stay was 3-7 days, with an average of 5 days. There was no obvious complication after operation. No local tumor recurrence or new bladder implantation metastasis has already been observed with the postoperative follow-up time in 8 to 40 months.Conclusion One-position complete retroperitoneal laparoscopic radical resection of UTUC is safe and feasible. The curative effect is affirmative. It has the conspicuous advantages in less bleeding during operation, minimally invasive, no posture change, quicker recovery with little disturbance of abdominal organ and shorter postoperative hospital stay, which could particularly reduce workload of operating room nurses, without any extra postoperative complications.

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Laparoscopic versus open nephroureterectomy to treat localized and/or locally advanced upper tract urothelial carcinoma: oncological outcomes from a multicenter study

Cited by 19 publications

References 30 publications

Comparison of perioperative outcomes between open and minimally invasive nephroureterectomy: A population‐based analysis

Comparison of perioperative outcomes between open and minimally invasive nephroureterectomy: A population‐based analysis

Current Status of Lymphadenectomy During Radical Nephroureterectomy for Upper Tract Urothelial Cancer—Yes, No or Maybe?

Clinical application of one-position complete retroperitoneal laparoscopic radical resection of renal pelvis and ureteral carcinoma

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