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

Nakamura, Kogenta; Nagata, D.; Kajikawa, Keishi; Kobayashi, Ichiro; Zennami, Kenji; Nishikawa, Genya; Yoshizawa, Takahiko; Tobiume, Motoi; Aoki, Shigeyuki; Yamada, Yoshiaki; Sumitomo, Makoto

doi:10.1111/j.1758-5910.2011.00110.x

Cited by 2 publications

(2 citation statements)

References 11 publications

(11 reference statements)

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“…The disadvantages include lack of prior cystoscopic mobilization of the distal juxtavesical ureter (laparoscopic difficulties); difficulty confirming the removal of the entire ureter; unoccluded distal ureter and continued urinary extravasation; tumor cell spillage and peri-vesical recurrence (directly T3); and risk of common iliac artery thrombosis, due to the need to cross the common iliac artery when handling the distal ureter ( 5 9), and even skin incision implantation. The recurrence rate associated with the stripping technique (24.0%) was higher than that associated with the pluck technique (19.3%) (13).…”

Section: Discussionmentioning

confidence: 68%

Initial satisfying experience of total retroperitoneal laparoscopic radical nephroureterectomy: a retrospective comparative research

Wang¹,

Yao²,

Jin³

et al. 2022

Transl Androl Urol

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Background: Radical nephroureterectomy (RNU) is the principal method for treatment of high-risk upper urinary tract urothelial carcinoma (UTUC). The transperitoneal approach is associated with poor disease progression, but the distal ureter-bladder cuff (DUBC) resection through retroperitoneal laparoscopic approach is difficult. This study proposed a modulated RNU technique, namely, total retroperitoneal laparoscopic radical nephroureterectomy (tRLRNU), with its advantages of DUBC resection and requiring fewer trocars etc. The efficiency, safety, and short-term impacts were retrospectively compared with total transperitoneal laparoscopic radical nephroureterectomy (tTLRNU).Methods: Total of 12 patients who received tRLRNU and 28 patients who received tTLRNU were enrolled. The choice of surgical approach was random and their data were retrospectively analyzed. During tRLRNU, the laparoscope was versed towards the caudal direction and a retroperitoneal laparoscopic ureterectomy was performed. The bladder cuff was entirely transected and the bladder incision was sutured.The tRLRNU cases were compared with the tTLRNU cases in terms of general clinical data, pathologic parameters, peri-operative parameters, adjuvant therapy, and short-term outcomes. The independent samples t-tests, chi-square tests, and Fischer exact tests were used to analyze the differences.Results: There were no significant differences in the basic patient characteristics between the 2 groups. The data were comparable. There were significantly fewer trocars utilized in tRLRNU group compared to tTLRNU group (P=0.0008). tRLRNU group experienced less blood loss (98.33±61.32 versus 170.71±121.32 mL; P=0.017), smaller drainage volume (182.08±163.60 versus 1,924.82±3,370.02 mL; P=0.011), and shorter extubation time (5.67±1.07 versus 8.57±6.96 days; P=0.040) compared to tRLRNU group. There were no statistically differences in the other peri-operative parameters, including whole operation time, transfusion, visceral and vascular injuries, open conversion, post-operative bleeding, recovery time of intestinal function, and discharge time. The patient outcomes in tTLRNU group at 6 months were significantly worse than that of tRLRNU group by comparing progression-free survival, progression survival and mortality (P=0.039). Conclusions:The tRLRNU was potentially safer, minimally invasive, and more effective compared to the tTLRNU. Due to the small sample size, short follow-up time and no randomization of the study, future comparative studies are warranted to further analyze long-term outcomes of tRLRNU.

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Section: Discussionmentioning

confidence: 68%

Initial satisfying experience of total retroperitoneal laparoscopic radical nephroureterectomy: a retrospective comparative research

Wang¹,

Yao²,

Jin³

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

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“… 26 PUCP is more likely to be recommended in surgeries involving retroperitoneal and pelvic area preoperatively due to its aids on identification and guidance of ureter. 27 , 28 Unfortunately, there is no study found specifically focused on the utilization of catheter and intraoperative UIs in RPS surgeries before. The largest RPS series reported from TARPSWG only disclosed a 0.4% (4/1007) percentage of urinal leak after RPS surgeries.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Ureteral Catheter Placement Appears to Reduce Intraoperative Ureteric Injury During Resection of Primary Retroperitoneal Liposarcoma

Chen

Cananzi

et al. 2022

Technol Cancer Res Treat

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Background: Prophylactic ureteral catheters placement (PUCP) was advocated as an effective strategy for decreasing ureteral morbidities in colorectal surgeries. However, whether it should be routinely used prior to primary retroperitoneal liposarcoma (PRLS) surgeries remains unknown. Methods: It was a retrospective study, conducted at a tertiary sarcoma center. Medical records of patients with PRLS undergoing surgeries from January 2015 through December 2018 were reviewed. Primary endpoint was the rate of ureteral morbidities during and after retroperitoneal liposarcoma resection procedures. Univariate and multivariate analyses determined risk factors associated with ureteral injury (UI) in patients undergoing surgeries. Results: A total of 55 patients of PRLS were included. Fourteen (25.5%) patients underwent PUCP, with 1 UI (7.1%) identified. In 41 patients with no PUCP, 15 (36.6%) exhibited UIs during and post surgeries. There were significant improvements of UIs in group PUCP, compared with patients without PUCP ( P < .05). Resection surgeries combined with colectomy and tumor-ureter relationship were 2 risk factors significantly associated to UIs ( P < .01). Conclusions: PUCP might be an effective way of preventing UIs in patients with PRLS. It could be suggested especially in patients with ureter encased by tumor or anticipated colectomy during the surgical process.

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

Cited by 2 publications

References 11 publications

Initial satisfying experience of total retroperitoneal laparoscopic radical nephroureterectomy: a retrospective comparative research

Initial satisfying experience of total retroperitoneal laparoscopic radical nephroureterectomy: a retrospective comparative research

Prophylactic Ureteral Catheter Placement Appears to Reduce Intraoperative Ureteric Injury During Resection of Primary Retroperitoneal Liposarcoma

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