Ureteroscopic management of upper tract transitional cell carcinoma and ureteropelvic obstruction

Abstract

Introduction:Technological advances have increased the application of the endoscopic management of upper tract transitional cell carcinoma (TCC) and ureteropelvic junction obstruction (UPJO).Materials and Methods:Published, peer-reviewed articles on endoscopic treatment of upper tract TCC and UPJO were identified using the MEDLINE database.Results:Although nephroureterectomy remains the gold standard for upper tract TCC treatment, low-grade, low-stage and small tumors, especially in patients with solitary kidneys or poor renal function can be managed with encouraging success rates, despite the considerable recurrence rate. Endoscopic alternatives to pyeloplasty for UPJO can be used especially in cases with absence of crossing vessels, stricture length less than 1.5 cm, severe hydronephrosis and renal function less than 30%.Conclusion:Proper patient selection is critical for the successful endoscopic management of treatment of upper tract TCC and UPJO.

Paradigm Shift in the Management of Upper Tract Urothelial Cancer

“…10 Other options kidney sparing approach for includes endoscopic ablation. 11 Which can be approached retrogradely by semirigid ureteroscope for ureteric and flexible uretroscope for pelvicalyceal tumour. 11 Percutaneous access can also be done to reach caliceal system that are inaccessible or difficult to manage by flexible URS, like lower pole but has got risk of tumour seeding.…”

“…11 Which can be approached retrogradely by semirigid ureteroscope for ureteric and flexible uretroscope for pelvicalyceal tumour. 11 Percutaneous access can also be done to reach caliceal system that are inaccessible or difficult to manage by flexible URS, like lower pole but has got risk of tumour seeding. Adjuvant treatment with topical instillation of topical agents like mitomycin or BCG has been tried, but the metaanalysis shows no difference in the recurrence rates.…”