Laparoscopic nephroureterectomy for upper tract transitional cell carcinoma: a critical appraisal

Abstract

Two of the mini‐reviews in this issue evaluate the laparoscopic approach to urology; one critically appraising laparoscopic nephroureterectomy for upper tract TCC, and the other looking back on the first 10 years of laparoscopic pyeloplasty. They are also a testament to the relationship which has developed between the effects of British urologists in becoming experts in this area, and the outstanding help and supervision given by Inderbir Gill and his team at the Cleveland Clinic. The financial backing for this venture came from the British Urological Foundation, which enthusiastically supports the concept of this preceptorship at the Cleveland Clinic.

Oncological outcome of retroperitoneoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma

“…The advantages of RNU for upper urinary tract TCC have been well proven in several comparative studies revealing a significant reduction of postoperative morbidity. 4,5 However, in the case of oncological indications, such advantages have to be balanced against possible risks, such as port site metastasis or local recurrence.…”

“…3 This surgery was soon replicated worldwide. 4 We have applied laparoscopic procedures to radical nephroureterectomy for transitional cell carcinoma of the upper urinary tract since January 2001 to minimize surgical morbidity. We sought to evaluate the oncological outcome for a group of patients undergoing retroperitoneoscopic nephroureterectomy (RNU) compared with a group undergoing traditional open nephroureterectomy (ONU) in our institution.…”

British Urological Foundation preceptorships to the Cleveland Clinic

“… It is well organized, taking the stress out of finding a department, making contact, doing paperwork, finding accommodation It has an enthusiastic and charismatic specialist who welcomes the BUF preceptors and makes them feel ‘special’ amongst the many other visitors, meeting them socially and encouraging them to write a review article with him [1–4]. The wet lab experience allows the visitors to practice things that they see without waiting for return home and an appropriate case. There is no language problem. …”

“…It has an enthusiastic and charismatic specialist who welcomes the BUF preceptors and makes them feel ‘special’ amongst the many other visitors, meeting them socially and encouraging them to write a review article with him [1–4].…”

Nueva técnica para la ureterectomía distal y excisión de manguito vesical

“…Desde que se hiciera la primera descripción de una nefroureterectomía radical por laparoscopia (NURL) en 1991 1 , se ha llegado a conclusiones positivas respecto a su viabilidad en diversos estudios en los que se exploraba la seguridad oncológica de esta técnica 2,3 . No obstante, está aún por resolver en gran medida cuál podría ser la técnica óptima para la realización de la ureterectomía distal con retirada del manguito vesical durante la nefroureterectomía laparoscópica.…”