Efficacy and safety of modified laparoscopic single-position radical nephroureterectomy with bladder cuff resection for upper urinary tract urothelial carcinoma: A single-center retrospective study.

Abstract

Background: Radical nephroureterectomy (RNU) with bladder cuff excision represents the standard treatment for high-risk upper tract urothelial carcinoma (UTUC).

Objective: This study aimed to evaluate the safety, feasibility, and clinical outcomes of a modified laparoscopic single-position RNU plus bladder cuff resection.

Methods: This retrospective analysis examined patients diagnosed with UTUC who underwent RNU between May 2022 and July 2024. Participants were divided into three groups: Group A (39 patients) underwent the modified technique, Group B (38 patients) received standard laparoscopic nephroureterectomy with bladder cuff resection, and Group C (27 patients) had laparoscopic nephroureterectomy with an additional lower abdominal incision for bladder cuff resection. We compared baseline characteristics, intraoperative variables, and post-operative outcomes among the groups.

Results: A total of 104 patients were included and analyzed. Their baseline characteristics showed no significant differences among groups (p>0.05). Group A experienced a significantly shorter operative time and earlier ureteral catheter removal compared to Groups B and C (p<0.05). Intraoperative blood loss, gastrointestinal recovery time, and length of hospital stay were comparable between Groups A and B, but the results in the two groups were more favorable against Group C (p<0.05). Follow-up revealed no significant differences in tumor recurrence and metastasis rates across groups (p>0.05).

Conclusion: The modified laparoscopic single-position RNU in combination with bladder cuff resection is a safe and effective minimally invasive approach for UTUC, offering advantages like reduced operative time, early catheter removal, and enhanced patient recovery, supporting its broader clinical application.