• Users Online: 443
  • Print this page
  • Email this page
Year : 2018  |  Volume : 29  |  Issue : 1  |  Page : 33-37

Do transperitoneal and retroperitoneal hand-assisted laparoscopic nephroureterectomy have different effects on intravesical recurrence?

1 Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
2 Department of Urology, National University Hospital, Taipei, Taiwan

Correspondence Address:
Che-Yuan Hu
National Cheng Kung University Hospital, Tainan
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/UROS.UROS_14_17

Rights and Permissions

Objectives: Some studies have shown that in patients with upper tract urothelial carcinoma (UTUC) who have undergone hand-assisted laparoscopic nephroureterectomy (HALNU), the narrow working space and inevitable manipulation that occurs during the retroperitoneal approach (RP-HALNU) enhances tumor cell seeding in the bladder mucosa. This study was an attempt to investigate the differences in intravesical recurrence between transperitoneal HALNU (TP-HALNU) and RP-HALNU. Patients and Methods: From 1999 to 2011, a total of 197 patients with UTUC were enrolled. After excluding those with a previous history of bladder cancer, 170 patients were analyzed. Sixty-five of these underwent RP-HALNU, and 105 of these underwent TP-HALNU. The median follow-up periods were 39.2 and 46.2 months. Tumor location was divided into three groups: In the renal pelvis, in the ureter, and in both the renal pelvis and ureter. Results: There was no significant difference in the intravesical recurrence rate in relation to the different surgical approaches (P = 0.10), but tumor location in both the renal pelvis and ureter significantly increased the risk (hazard ratio [HR] = 3.11, P = 0.01). In addition, advanced T stage (HR = 9.63, P < 0.01) was the only significant risk factor related to death. Conclusions: In patients with UTUC, tumor location in both the renal pelvis and ureter determined higher susceptibility to intravesical recurrence. However, different surgical approaches to HALNU were not a significant risk factor for intravesical recurrence.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded230    
    Comments [Add]    
    Cited by others 1    

Recommend this journal