title: Comparative study of ureteral stripping versus open ureterectomy for nephroureterectomy in patients with transitional carcinoma of the renal pelvis.
abstract: OBJECTIVE
  To evaluate the clinical outcome of nephroureterectomy with endoscopically assisted transurethral ureteral stripping for transitional cell carcinoma of the renal pelvis in a comparative study.
  
  
  METHODS
  Sixty patients with localized renal pelvic cancer were enrolled in a prospective comparative nonrandomized study. Of these, 28 patients underwent nephroureterectomy with endoscopically assisted transurethral ureteral stripping and 32 underwent conventional nephroureterectomy with a bladder cuff. Both short-term and long-term results were analyzed in this series.
  
  
  RESULTS
  The operating time for patients with ureteral stripping was significantly shorter than for those with a standard two-incision nephroureterectomy (median 183 versus 250 minutes, P = 0.0231), and the amount of blood loss was significantly less (median 150 versus 390 mL, P = 0.0002). Intravesical recurrence was detected in 10 (35.7%) of the 28 patients with ureteral stripping, and the 1-year and 3-year recurrence-free rate was 68.0% and 57.7%, respectively. Seven patients treated by the standard two-incision nephroureterectomy (21.9%) experienced intravesical recurrence, with a 1-year and 3-year recurrence-free rate of 96.8% and 75.0%, respectively. The recurrence rate was significantly greater in the group with ureteral stripping (P = 0.0287).
  
  
  CONCLUSIONS
  Compared with conventional nephroureterectomy with a bladder cuff, nephroureterectomy with transurethral stripping is a minimally invasive procedure with a shorter operating time and less blood loss, but a statistically significantly greater intravesical recurrence rate. Greater consideration should be taken before selecting this procedure.
authors.affiliation: Department of Urology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Saika
authors.forename: Jun
authors.initials: J
authors.lastname: Nishiguchi
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Tsushima
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Nasu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nagai
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Miyaji
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Maki
authors.forename: Teruaki
authors.initials: T
authors.lastname: Akaeda
authors.forename: Michihisa
authors.initials: M
authors.lastname: Saegusa
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kumon
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000556:secondary / Q000601:surgery*; D003558:Cystoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014513:Ureter / Q000601:surgery*; D018666:Ureteroscopy; D001749:Urinary Bladder Neoplasms / Q000556:secondary