[Management of distal ureter in laparoscopic nephroureterectomy].

Abstract:

INTRODUCTION:Nephroureterectomy is one of the procedures for which a laparoscopic approach is more clearly indicated. However, despite the long experience available, management of the distal ureter is still difficult. MATERIALS AND METHODS:Thirty-two laparoscopic nephroureterectomies were performed from November 2004 to December 2008. The procedure used was endoscopic resection of distal ureter and earlier ligation of the ureter in the laparoscopic time in 13 patients, a laparoscopic bladder cuff in 13 patients, and an open bladder cuff in 3 patients. RESULTS:Mean operating time was 221.53 min (125-315 min), and mean postoperative stay of 27 patients was 4.6 days. Conversion to open surgery and discontinuation of the procedure for local tumor progression were required in one patient each. Mean patient follow-up was 17.8 months. No local relapse or metastasis occurred in the ports. CONCLUSION:The most common procedures continue to be endoscopic resection and the open bladder cuff depending on indication. Any laparoscopic approach to upper urothelial tumors must strictly comply with oncological principles. The reported procedure is in our experience the fastest, most simple, and most effective for this purpose. In our opinion, the therapeutic algorithm provided is adequate for management of the distal ureter in laparoscopic nephroureterectomy.

journal_name

Actas Urol Esp

authors

Alonso Y Gregorio S,Sánchez S,Monasterio S,Girón M,Rando A,Tabernero A,Hidalgo L,Cisneros J,de la Peña JJ

subject

Has Abstract

pub_date

2010-02-01 00:00:00

pages

165-9

issue

2

eissn

0210-4806

issn

1699-7980

pii

13148731

journal_volume

34

pub_type

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