Mayo Clinic Scottsdale Experience with laparoscopic nephroureterectomy

To evaluate the efficacy of laparoscopic nephroureterectomy for patients with transitional cell carcinoma of the upper urinary tract. Eighteen patients underwent attempted transperitoneal laparoscopic nephroureterectomy between June 2000 and October 2002. Mean patient age was 67.5 years. The specime...

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Bibliographic Details
Published in:Journal of the Society of Laparoendoscopic Surgeons 2004-04, Vol.8 (2), p.109-113
Main Authors: Simon, Scott D, Ferrigni, Robert G, Novicki, Donald E, Lamm, Donald L, Swanson, Scott S, Andrews, Paul E
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carcinoma, Transitional Cell - pathology
Carcinoma, Transitional Cell - surgery
Female
Humans
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Laparoscopy - methods
Male
Middle Aged
Neoplasm Staging
Nephrectomy - methods
Scientific Papers
Treatment Outcome
Ureter - surgery
Ureteral Neoplasms - pathology
Ureteral Neoplasms - surgery
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Summary:To evaluate the efficacy of laparoscopic nephroureterectomy for patients with transitional cell carcinoma of the upper urinary tract. Eighteen patients underwent attempted transperitoneal laparoscopic nephroureterectomy between June 2000 and October 2002. Mean patient age was 67.5 years. The specimen was removed intact through a 7- to 9-cm extraction incision in the lower midline. In the majority of patients, the distal ureter was dissected through the extraction incision. Sixteen cases were completed laparoscopically. Two cases required conversion to an open procedure. In these cases, dense fibrosis was present around the renal hilum preventing further dissection. The mean operative time was 180 minutes, and the mean estimated blood loss was 160 mL. The mean length of stay was 3.3 days. Complications included the 2 conversions, and 1 patient with a postoperative Mallory Weiss tear. No port-site or distant metastasis occurred; however, 1 patient developed a retroperitoneal recurrence. Laparoscopic nephroureterectomy is an alternative to open nephroureterectomy. Cases with high-stage and grade may cause the laparoscopic dissection to be difficult. The extraction incision allows for easy dissection of the distal ureter.
ISSN:1086-8089
1938-3797