First Report of Laparoscopic Radical Nephroureterectomy Following Extraperitoneal Tubeless Umbilical Cutaneous...

Extraperitoneal tubeless umbilical cutaneous ureterostomy is a useful urinary diversion technique for patients with shortened ureters or high risk of upper urinary tract recurrence. However, radical nephroureterectomy following this diversion has not been previously reported.

A 67-year-old man underwent radical cystoprostatourethrectomy with extraperitoneal tubeless umbilical cutaneous ureterostomy for high-risk urothelial carcinoma with bilateral ureteral shortening. Twenty-four months later, left-sided upper tract urothelial carcinoma was diagnosed, and laparoscopic left radical nephroureterectomy was performed. Although dense adhesions necessitated partial small-bowel resection, complete nephroureterectomy was achieved without major complications.

To the best of our knowledge, this is the first report of radical nephroureterectomy performed after umbilical cutaneous ureterostomy. This urinary diversion may represent a reasonable option for selected patients at high risk of upper urinary tract recurrence.