Original Article

 

Authors: Il. Saltirov, Ts. Petkov, G. Georgiev, K. Petkova
Department of Urology and Nephrology, Military Medical Academy, Sofia

Author for contacts: Il. Saltirov, Military Medical Academy, Department of Urology and Nephrology, 3 “G.Sofiiski” Blvd., Sofia 1606, phone: +359 2 922 52 08, fax: +359 2 851 70 94

 

Keywords: transitional cell carcinoma of the upper urinary tract, nephroureterectomy, transurethral endoscopic ureterectomy

 

Abstract
Introduction: Radical nephroureterectomy with resection of a bladder cuff remains the “gold standard” in the treatment of upper urinary tract transitional cell tumors. McDonald is the first to describe a ureteral stripping technique with subsequent endoscopic resection of the bladder cuff around the ureteral orifice during nephroureterectomy, which is called transurethral endoscopic ureterectomy and is a less invasive alternative of open surgical ureterectomy in patients with transitional cell renal pelvic carcinoma.
Objective: To evaluate the clinical outcome of transurethral endoscopic ureterectomy during nephroureterectomy for transitional cell carcinoma of the renal pelvis and calyces.
Materials and methods: Between January 1997 and July 2009, 24 patients with transitional cell renal pelvic carcinoma underwent nephroureterectomy.
Results: 21 patients underwent nephroureterectomy with transurethral endoscopic ureterectomy, and 3 patients – standart two-incision nephroureterectomy, due to ureteral stripping failure. No postoperative complications and no postoperative bladder or locoregional recurrent tumors developed during follow-up.
Conclusion: Transurethral endoscopic ureterectomy during nephroureterectomy for upper urinary tract transitional cell carcinoma is a less invasive surgical technique with several advantages compared to standard two-incision nephroureterectomy. A disadvantage of this technique is the risk of stripping failure, which does not hamper the open surgical removal of the ureter.