Ureteral Resections in Non-urological Cancer Surgeries: Experience from a Tertiary Cancer Center.

Abstract

Radical surgeries for abdominopelvic and retroperitoneal malignancies sometimes necessitate Ureteral resections due to tumor involvement. Preservation of renal function is crucial in such cases, especially considering the systemic therapy needs of oncology patients. The objectives were to study the indications, the common reconstructive methods, surgical complications, ureteral patency rates, and postoperative complications. This retrospective study included 20 patients who underwent Ureteral resection and reconstruction between 2013 and 2023 at a tertiary cancer institute. Among 1800 patients undergoing major abdominal surgeries for non-urologic malignancies, 20 required Ureteral resections. The most common malignancy was colorectal adenocarcinoma (65%). The distal ureter was most frequently involved (85%). Ureteroureterostomy(35%) and ureteroneocystostomy(45%) were the predominant reconstruction techniques. Histopathologically tumor infiltration of the ureter was noted in 20% of patients. Acute complications included anastomotic leak (20%), septic shock (20%), and urinary fistulae (5%). Of the 16 survivors, 25% developed renal function derangement, 25% had urinary incontinence, and one had a Ureteral stricture requiring intervention. Ureteralresection and reconstruction, makes surgical resection of the prmary lesionpossible along with multivisceral resections for non-urological malignancies,but with a potential for morbidity. Ureteroureterostomy is the most commonprocedure of choice for upper and mid ureter injuries, whileureteroneocystostomy for lower zone or pelvic ureter. Most individualsrequiring a ureteral resection and reconstruction for non-urothelial tumors hadpreserved renal function over long-term.