Transperitoneal laparoscopic nephroureterectomy for native upper tract urothelial carcinoma in renal transplant recipients

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• 作者：Ji-Tao Wu (1)
  Feng-Chun Wan (1)
  Zhen-Li Gao (1)
  Jian-Ming Wang (1)
  Dian-Dong Yang (1)
  
• 关键词：Laparoscopy ; Nephroureterectomy ; Renal transplant ; Urothelial carcinoma
• 刊名：World Journal of Urology
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：31
• 期：1
• 页码：135-139
• 全文大小：187KB
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• 作者单位：Ji-Tao Wu (1)
  Feng-Chun Wan (1)
  Zhen-Li Gao (1)
  Jian-Ming Wang (1)
  Dian-Dong Yang (1)
  
  1. Department of Urology, Yantai Yuhuangding Hospital, Yantai, 264000, Shandong Province, China
  
• ISSN：1433-8726

文摘

Purpose To analyze the safety and clinical outcome of laparoscopic nephroureterectomy (LNUT) for native upper tract urothelial carcinoma (UC) in renal transplant (RT) recipients. Methods We conducted a retrospective analysis of 956 RT recipients from January 2003 to December 2010 to evaluate the benefit of LNUT for patients who were diagnosed with de novo UC after renal transplantation. Results Women predominated (10/11, 91?%) in the 11 patients with upper tract UC who underwent LNUT. Five patients underwent LNUT ipsilateral to the transplanted kidney, 4 patients underwent contralateral LNUT, and 2 patients underwent bilateral LNUT. Nine were operated with LNUT combining resection of bladder cuff, 2 with right ureteral cancer underwent open ureterectomy with bladder cuff due to severe adhesions attached to the lesion. The mean surgical duration was 184.2?min (105-05), the mean blood loss was 182.3?ml (20-00), and the mean hospitalization time was 6.7?days (5-). The mean levels of preoperative and postoperative serum creatinine were 0.99?mg/dl (0.78-.16) and 1.01?mg/dl (0.89-.18), respectively. No intraoperative complications occurred. One patient died of multiple metastases at 13?months after LNUT. The mean follow-up of the remaining 10 patients after diagnosis was 21.7?months (3-8). Two patients had recurrent bladder cancer and underwent transurethral resection of the tumor. Eight patients showed no evidence of disease during the follow-up. Conclusions LNUT is a safe and effective approach with low morbidity in transplant recipients, and this therapy provides less trauma, quicker recovery, and acceptable oncological outcomes.