title: Combined surgery for intra-abdominal extra-urinary lesions in patients with renal and/or ureteral malignancies.
abstract: BACKGROUND
  The standard treatment for patients with renal and/or ureteral malignancies is radical nephrectomy or nephroureterectomy. Frequently, intra-abdominal extra-urinary lesions are noted preoperatively or intra-operatively in the gastrointestinal or gynecologic tract. We reviewed our experience with patients during an 11-year period.
  
  
  METHODS
  From 1991 through 2001, 1059 patients underwent radical operations for renal and/or ureteral malignancies. Of these, 37 patients had simultaneous intra-abdominal extra-urinary lesions preoperatively or intra-operatively and underwent surgery for these lesions at the same time as nephrectomy or nephroureterectomy. These patients were designated as group A and were compared with group B patients who underwent only radical urological surgery.
  
  
  RESULTS
  The distributions of age, gender, preoperative evaluations, and histology did not differ significantly between the groups. The most common intra-abdominal extra-urinary lesion was located in the gall bladder (51.4%). Although the patients with intra-abdominal extra-urinary lesions tended to have greater intra-operative blood loss (p = 0.8621), longer postoperative hospital stays (p = 0.3414), and higher complication rates (p = 0.208) than those who did not, the differences were not significant.
  
  
  CONCLUSIONS
  Given radical operations for renal and/or ureteral malignancies, synchronous surgery for intra-abdominal extra-urinary lesions is feasible and safe with thorough postoperative care.
authors.affiliation: Department or Urology, Chang Gung Memorial Hospital, Taipei, ROC.
authors.forename: Tso-Hsuan
authors.initials: TH
authors.lastname: Wang
authors.forename: Ming-Li
authors.initials: ML
authors.lastname: Hsieh
authors.forename: Ke-Hung
authors.initials: KH
authors.lastname: Tsui
authors.forename: Ta-Min
authors.initials: TM
authors.lastname: Wang
authors.forename: Shih-Tsung
authors.initials: ST
authors.lastname: Huang
authors.forename: Phei-Lang
authors.initials: PL
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications* / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D007680:Kidney Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000150:complications / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods