LAPAROSCOPIC NEPHROURETERECTOMY FOR UPPER TRACT TRANSITIONAL CELL CANCER: THE WASHINGTON UNIVERSITY EXPERIENCE

Abstract

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Apr 2000LAPAROSCOPIC NEPHROURETERECTOMY FOR UPPER TRACT TRANSITIONAL CELL CANCER: THE WASHINGTON UNIVERSITY EXPERIENCE ARIEH L. SHALHAV, MATTHEW D. DUNN, ANDREW J. PORTIS, ABDELHAMID M. ELBAHNASY, ELSPETH M. M c DOUGALL, and RALPH V. CLAYMAN ARIEH L. SHALHAVARIEH L. SHALHAV , MATTHEW D. DUNNMATTHEW D. DUNN , ANDREW J. PORTISANDREW J. PORTIS , ABDELHAMID M. ELBAHNASYABDELHAMID M. ELBAHNASY , ELSPETH M. M c DOUGALLELSPETH M. M c DOUGALL , and RALPH V. CLAYMANRALPH V. CLAYMAN View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67701-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Laparoscopic nephroureterectomy has only recently been done to treat patients with upper tract transitional cell carcinoma. We retrospectively evaluated our experience with and long-term followup of laparoscopic nephroureterectomy, compared our results to those of contemporary series of open nephroureterectomy and reviewed the literature. Materials and Methods: We reviewed the charts of and followed up by telephone 25 patients who underwent laparoscopic nephroureterectomy between May 1991 and June 1998, and 17 who underwent open nephroureterectomy between March 1990 and January 1997. Demographic, perioperative and followup data were compared. We performed a MEDLINE search and reviewed the literature on laparoscopic nephroureterectomy for upper tract transitional cell carcinoma. Results: Laparoscopic nephroureterectomy required twice the operating time of open nephroureterectomy (7.7 versus 3.9 hours). However, patients who underwent the laparoscopic procedure had a 74% decrease in analgesia requirements (37 versus 144 mg. morphine sulfate equivalent), a 63% shorter hospital stay (3.6 versus 9.6 days) and a 72% more rapid convalescence (2.8 versus 10 weeks). Subsequent bladder transitional cell carcinoma and overall cancer specific survival were similar at a mean followup of 2 years. There was no sign of trocar site or peritoneal seeding after laparoscopic nephroureterectomy. Conclusions: Although laparoscopic nephroureterectomy is a longer operation, it has the same efficacy and is better tolerated by patients than open nephroureterectomy for upper tract transitional cell carcinoma. As operating time decreases due to surgeon experience and the recent development of hand assisted laparoscopy, laparoscopic nephroureterectomy may soon become the procedure of choice for the ablative management of upper tract transitional cell carcinoma. 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Volume 163Issue 4April 2000Page: 1100-1104 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordslaparoscopic surgical procedurekidneynephrectomycarcinoma, transitional cellMetricsAuthor Information ARIEH L. SHALHAV More articles by this author MATTHEW D. DUNN More articles by this author ANDREW J. PORTIS More articles by this author ABDELHAMID M. ELBAHNASY More articles by this author ELSPETH M. M c DOUGALL More articles by this author RALPH V. CLAYMAN More articles by this author Expand All Advertisement PDF downloadLoading ...