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Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...

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Updated: Jun 28, 2026

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

Published on: November 22, 2019

Pathologic upstaging after laparoscopic radical nephrectomy.

Mahesh C Goel¹, Yousef Mohammadi, Amanjot S Sethi

¹Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.

Journal of Endourology

|October 22, 2008

Summary

This summary is machine-generated.

Accurate renal cancer staging is crucial. Histopathology after laparoscopic radical nephrectomy (LRN) revealed 31% of patients were upstaged, impacting treatment and prognosis.

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Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer

Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer

Published on: October 31, 2025

Area of Science:

Urology
Oncology
Surgical Pathology

Background:

Accurate tumor staging in renal cancer is critical for prognosis, follow-up, clinical trials, and systemic therapies.
Laparoscopic radical nephrectomy (LRN) is a common surgical approach for renal tumors.

Purpose of the Study:

To determine the extent of upstaging in renal cell cancer patients following LRN based on histopathology.
To correlate clinical and pathological staging and identify factors contributing to upstaging.

Main Methods:

Retrospective review of 123 patients undergoing LRN for renal cell cancer.
Clinical staging based on CT/MRI and preoperative workup (AJCC TNM criteria).
Histopathology evaluation for p-stage, lymph node (LN) status, and features causing upstaging; statistical analysis performed.

Main Results:

31% (38/123) of patients were upstaged after histopathology.
Upstaging causes included renal sinus fat involvement (8), renal/adrenal vein involvement (14), and focal perirenal fat involvement (6).
LN metastasis was detected in 5 patients, with one case in a T1a stage tumor.

Conclusions:

Pathologic upstaging of renal neoplasms occurs in approximately 31% of patients post-LRN.
Downstaging is less frequent, and mean tumor size does not significantly change between clinical and pathological assessment.