Modified Nephro‐ureterectomy. Long‐term Follow‐up with Particular Reference to Subsequent Bladder Tumours

Abstract

Nephro-ureterectomy is the standard treatment for transitional carcinoma of the renal pelvis and caliceal system. In recent years a modification of the conventional two-incision technique has been described in which the intramural ureter is resected endoscopically and the remaining ureter is removed in continuity with the kidney through a single loin incision. Twenty-one patients had their renal pelvic tumours treated by this modified technique between 1970 and 1983. Of 16 patients available for analysis, 37.5% subsequently developed bladder tumours. It was concluded that this modified technique has no greater incidence of subsequent bladder tumour development than the conventional technique of nephro-ureterectomy, whilst giving considerable benefit to the patient.

Bladder recurrence of upper urinary tract cancer after laparoscopic surgery

“…Recurrence of bladder tumors has been observed in 20-40% of cases with upper urinary tract cancers [1,4,5,9,[14][15][16]. In the ''pre-laparoscopic era'', risk factors reported for bladder recurrence included low pT stage and tumor multiplicity [14,15].…”

Renal imaging: what the urologist wants to know

“…Tumor stage and grade are the most useful prognostic variables, with stage the more accurate predictor of prognosis [48,54,55]. Low-stage, lowgrade tumors are the most amenable to endoscopic treatment, but approximately 50% to 60% of renal pelvis tumors are invasive [56].…”

“…Bilateral involvement of the upper tract can occur in 2% to 5% of cases and upper-tract tumors occur in 2% to 4% of patients who have bladder cancers [42][43][44][45]. Furthermore, 25% to 75% of patients who have upper-tract urothelial tumors have bladder tumors at some point, which suggests the importance of routine endoscopic and imaging follow-up [46][47][48][49][50][51].…”

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

“…Abercrombie et al [35], caused significant concern after reports of tumour seeding into the peritoneum from the open distal end of the ureter [36,37].…”