Wentao Liu1, Yinhuai Wang1, Zhaohui Zhong1, Hongyi Jiang1, Shifeng Ouyang1, Liang Zhu2, Ran Xu1. 1. Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China. 2. Department of Urology, The Second Xiangya Hospital of Central South University, Renmin Road, Changsha, Hunan, China. zhuliang_xy2yy@163.com.
Abstract
BACKGROUND: Radical nephroureterectomy is considered as the gold standard for the surgical treatment of upper urinary tract urothelial carcinoma (UTUC). Laparoscopic radical nephroureterectomy (LNU) can be performed via the transperitoneal (TLNU) or retroperitoneal (RLNU) approach, and each one has its own advantages and limitations. Our study was conducted to describe the difference between TLNU and RLNU by comparing the perioperative outcomes. METHODS: From January 2009 to October 2014, 68 patients underwent TLNU or RLNU at our center were retrospectively collected and 1:1 matched for age, body mass index and tumor side. Baseline characteristics and perioperative outcomes were evaluated and compared, respectively. RESULTS: There were no significant differences between the TLNU and RLNU group in terms of baseline characteristics, operating time, estimated blood loss, visual analogue pain scale, cosmetic results, intraoperative and postoperative complication rate. Compared to TLNU approach, RLNU was associated with a quicker time to first oral intake (2.9 vs 2.0 days, p = 0.02) and hospital discharge (6.7 vs 5.6 days, p = 0.02). CONCLUSION: Both transperitoneal and retroperitoneal laparoscopic approaches are safe and effective methods for treatment of UTUC. Retroperitoneal approach has the advantage in terms of quicker bowel recovery and shorter hospital discharge.
BACKGROUND: Radical nephroureterectomy is considered as the gold standard for the surgical treatment of upper urinary tract urothelial carcinoma (UTUC). Laparoscopic radical nephroureterectomy (LNU) can be performed via the transperitoneal (TLNU) or retroperitoneal (RLNU) approach, and each one has its own advantages and limitations. Our study was conducted to describe the difference between TLNU and RLNU by comparing the perioperative outcomes. METHODS: From January 2009 to October 2014, 68 patients underwent TLNU or RLNU at our center were retrospectively collected and 1:1 matched for age, body mass index and tumor side. Baseline characteristics and perioperative outcomes were evaluated and compared, respectively. RESULTS: There were no significant differences between the TLNU and RLNU group in terms of baseline characteristics, operating time, estimated blood loss, visual analogue pain scale, cosmetic results, intraoperative and postoperative complication rate. Compared to TLNU approach, RLNU was associated with a quicker time to first oral intake (2.9 vs 2.0 days, p = 0.02) and hospital discharge (6.7 vs 5.6 days, p = 0.02). CONCLUSION: Both transperitoneal and retroperitoneal laparoscopic approaches are safe and effective methods for treatment of UTUC. Retroperitoneal approach has the advantage in terms of quicker bowel recovery and shorter hospital discharge.
Authors: Giuseppe Nigri; Alan S Rosman; Niccolò Petrucciani; Alessandro Fancellu; Michele Pisano; Luigi Zorcolo; Giovanni Ramacciato; Marcovalerio Melis Journal: Surgery Date: 2012-08-30 Impact factor: 3.982
Authors: Nawar Hanna; Maxine Sun; Quoc-Dien Trinh; Jens Hansen; Marco Bianchi; Francesco Montorsi; Shahrokh F Shariat; Markus Graefen; Paul Perrotte; Pierre I Karakiewicz Journal: Eur Urol Date: 2011-12-22 Impact factor: 20.096
Authors: Evanguelos Xylinas; Michael Rink; Eugene K Cha; Thomas Clozel; Richard K Lee; Harun Fajkovic; Evi Comploj; Giacomo Novara; Vitaly Margulis; Jay D Raman; Yair Lotan; Wassim Kassouf; Hans-Martin Fritsche; Alon Weizer; Juan I Martinez-Salamanca; Kazumasa Matsumoto; Richard Zigeuner; Armin Pycha; Douglas S Scherr; Christian Seitz; Thomas Walton; Quoc-Dien Trinh; Pierre I Karakiewicz; Surena Matin; Francesco Montorsi; Marc Zerbib; Shahrokh F Shariat Journal: Eur Urol Date: 2012-05-04 Impact factor: 20.096