Hand-assisted laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma
Jay D Raman1, Michael A Palese, Casey K Ng
1Department of Urology, The New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York 10021, USA. jay_d_raman@yahoo.com
Summary
Hand-assisted laparoscopic nephroureterectomy (HALN) offers a less invasive option for upper urinary tract cancer, showing reduced blood loss and shorter hospital stays compared to open nephroureterectomy (ON) with similar oncologic outcomes.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Upper urinary tract transitional cell carcinoma (TCC) is a rare malignancy.
- Nephroureterectomy is the standard surgical treatment.
Purpose of the Study:
- To compare the outcomes of hand-assisted laparoscopic nephroureterectomy (HALN) versus open nephroureterectomy (ON) for upper tract TCC.
Main Methods:
- Retrospective review of 90 patients undergoing nephroureterectomy for upper tract TCC between 1996 and 2003.
- 38 patients underwent HALN, and 52 underwent ON.
- Comparison of operative time, blood loss, complications, hospital stay, and oncologic outcomes.
Main Results:
- HALN demonstrated significantly less estimated blood loss (191 mL vs. 478 mL) and shorter hospital stays (4.6 days vs. 7.1 days) compared to ON.
- Operative times and complication rates were similar between the groups.
- Intermediate-term oncologic outcomes, including tumor recurrence rates (40% HALN vs. 50% ON), were comparable.
Conclusions:
- Hand-assisted laparoscopic nephroureterectomy is a safe and effective treatment for upper urinary tract urothelial carcinoma.
- HALN offers advantages of reduced blood loss and shorter hospitalization without compromising oncologic results.
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