Open Distal Ureterectomy and Boari Flap Reconstruction for Distal Ureteric Transitional Cell Carcinoma

Abstract

The standard surgical treatment of distal ureteric transitional cell carcinoma remains nephroureterectomy with excision of a cuff of bladder. We present a series of 20 patients who were managed with open distal ureterectomy and Boari flap reconstruction. Objective: To study the suitability of open distal ureterectomy and Boari flap reconstruction in the management of distal ureteric TCC. Methods: Data was collected retrospectively on one consultant's patients, operated on between 2004-2015. Results:We treated 20 patients with a mean age of 71 years (55-88 years). There were thirteen males and seven females. Six tumours were on the right and fourteen on the left. The mean follow up was 79 months (6.5 years) (8-144 months) with three recurrences (2 ureteric, 1 renal pelvis). There has been only one complication. Conclusion:Upper urinary tract tumours are rare. Radical nephroureterectomy with excision of bladder cuff may over treat this disease compromising renal function unnecessarily. In selected cases open distal ureterectomy and Boari flap reconstruction may be considered.