title: [Laparoscopic nephroureterectomy for upper urinary tract urothelial tumors].
abstract: OBJECTIVE
  We present our 11 year experience with 15 laparoscopic nephroureterectomy procedures for upper urinary tract urothelial tumor.
  
  
  RESULTS
  The tumor site was pyelocalyceal in 9 cases, ureteral in 4, and multifocal in one. All cases were urothelial tumors grade II or III; stage was Ta-T1 in 9 cases, T2 in three, T3 in two, and T4 in one. Transperitoneal approach was performed in 14 cases, whereas only one retroperitoneal. Hand assisted laparoscopy was performed in five cases. Seven specimens were extracted after morcellation without any recorded tumor seeding attributable to this manoeuvre. We recorded one case of sudden death due to pulmonary embolism 48 hours after the procedure, one case of intestinal obstruction secondary to an ileal loop hernia through the parietal orifice of one of the trocars, and one case of unstable angina pectoris. Two patients died because of disease progression, one of them after bladder recurrence.
  
  
  CONCLUSIONS
  We think that hand assisted laparoscopy is a good indication for nephroureterectomy for upper urinary tract urothelial tumor. We propose a new procedure to avoid possible tumor cell spilling at the time of ureterectomy, which simplifies the operation very much at the same time.
authors.affiliation: Servicio de Urología del Hospital Clinico Universitario "Lozano Blesa", Zaragoza, España. uroh@hcu-lblesa.es
authors.forename: José Gabriel
authors.initials: JG
authors.lastname: Valdivia Uría
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Sánchez Zalabardo
authors.forename: Oscar
authors.initials: O
authors.lastname: Regojo Zapata
authors.forename: Angel
authors.initials: A
authors.lastname: Elizalde Benito
authors.forename: Joaquín
authors.initials: J
authors.lastname: Navarro Gil
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000473:pathology / Q000601:surgery*; D014551:Urinary Tract / Q000473:pathology / Q000601:surgery