Full retroperitoneoscopic radical nephroureterectomy with intracorporeal, extravesical bladder cuff excision - surgical technique and early outcomes.

IF 2 4区医学 Q2 SURGERY

Minimally Invasive Therapy & Allied Technologies Pub Date : 2025-09-11 DOI:10.1080/13645706.2025.2555427

Alessandro Marquis, Francesco Soria, Marco Oderda, Daniele Dutto, Fulvia Colucci, Federico Lavagno, Livoti Simone, Matteo Rosazza, Marco Allasia, Paolo Destefanis, Beatrice Lillaz, Paolo Gontero

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引用次数: 0

Abstract

Background: The purpose of this study was to illustrate the technique of our full retroperitoneoscopic radical nephroureterectomy (frRNU) involving an intracorporeal, extravesical bladder cuff excision (BCE) and assess its safety and early oncological outcomes.

Methods: Between June 2020 and November 2023, 27 patients underwent frRNU for upper tract urothelial carcinoma. Surgical and oncological outcomes were assessed.

Results: Two (7%) patients were converted to open distal ureterectomy due to extensive fibrosis of the iliac ureter. Lymph node dissection (LND) was performed in 85% of procedures. Median operative time and blood losses were 230 (IQR: 188, 255) minutes and 125 (IQR: 100, 150) mL, respectively. Complication rate was 33%, with only two (7%) Clavien Dindo ≥ 3 complications and two (7%) patients experienced urinary fistula. Catheter was removed after six (IQR: 5, 7) days. All patients had negative surgical margins and three (11%) were pN+, with 6.5 (IQR: 3, 14) nodes removed. At a median follow-up of 11 (IQR: 3, 25) months, four (15%) patients had bladder recurrence, while no retroperitoneal recurrence occurred.

Conclusions: Our frRNU is feasible and safe, allowing for appropriate BCE and LND. Surgical outcomes are optimal, complication rate acceptable and short-term oncological outcomes promising.

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经腹膜后腹腔镜下肾输尿管根治性全切除术联合体外膀胱袖切除-手术技术及早期结果。

背景：本研究的目的是阐明我们的全后腹膜镜下肾输尿管根治性切除术（frRNU）的技术，包括体内、体外膀胱袖切除术（BCE），并评估其安全性和早期肿瘤预后。方法：2020年6月至2023年11月，27例上尿路上皮癌患者接受了frRNU治疗。评估手术和肿瘤预后。结果：2例（7%）患者由于髂输尿管广泛纤维化而转行远端输尿管切除术。85%的手术进行了淋巴结清扫（LND）。中位手术时间和出血量分别为230 （IQR: 188、255）分钟和125 (IQR: 100、150)mL。并发症发生率为33%，仅有2例（7%）出现Clavien Dindo≥3并发症，2例（7%）出现尿瘘。6天后（IQR: 5,7）拔除导管。所有患者手术切缘均为阴性，3例（11%）为pN+，切除了6.5个（IQR: 3,14）个淋巴结。中位随访11个月（IQR: 3.25）， 4例（15%）患者膀胱复发，腹膜后无复发。结论：我们的frRNU是可行和安全的，允许适当的BCE和LND。手术效果最佳，并发症发生率可接受，短期肿瘤预后良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.