Videoendoscopic cutaneous ureterostomy for palliative urinary diversion in advanced pelvic cancer.
Since January 1993, 9 patients with bilateral ureteral obstruction due to advanced pelvic cancers underwent videoendosurgical cutaneous ureterostomy. Five patients had prostate cancer, 3 had uterine cancer and only 1 bladder cancer. In 5 cases a bilateral laparoscopic transperitoneal procedure was performed. In 4 cases a retroperitoneal laparoscopic technique was adopted and only in 1 out of these 4 cases the procedure was done bilaterally. All the procedures were done under general anesthesia. The procedure was accomplished in all the cases without any intraoperative complication; the operative time ranged between 35 and 130 min. Postoperative pain was rather insignificant and did not require additional medication. Postdiversion hospital stay ranged from 3 to 11 days according to the general condition of the patients. The mean follow-up is 10.8 months. In conclusion, retroperitoneal laparoscopic cutaneous ureterostomy seems to be a reasonable alternative to percutaneous nephrostomy in case of bilateral ureteral obstruction due to advanced prostate or uterine cancer, provided that the clinical condition of the patient allows general anesthesia.
Puppo
P
P
Department of Urology, S. Corona Hospital, Pietra Ligure (SV), Italy.
Ricciotti
G
G
Bozzo
W
W
Pezzica
C
C
Geddo
D
D
Perachino
M
M
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010386:Pelvic Neoplasms / Q000150:complications*; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D014519:Ureterostomy / Q000379:methods*; D014547:Urinary Diversion / Q000379:methods*; D014741:Video Recording