title: [Place of laparoscopic nephroureterectomy in the treatment of upper urinary tract transitional cell carcinoma].
abstract: The current reference treatment for upper urinary tract transitional cell carcinoma is open nephroureterectomy via a lumbar incision and an iliac incision with resection of a large bladder cuff: Since the first laparoscopic nephroureterectomy performed in 1991, several teams have studied this approach for the treatment of urinary tract tumours. Laparoscopy has the advantage of decreased morbidity for the patient and allows early return to work. Recent published series do not demonstrate any difference in terms of cancer control between open and laparoscopic nephroureterectomy. However, the follow-up of laparoscopic nephroureterectomy is still limited and the safety of this technique has not been fully demonstrated. It therefore appears preferable to limit the indications for laparoscopic nephroureterectomy to small and/or low-grade tumours to avoid excessive manipulation of large transitional cell carcinomas in a gaseous atmosphere that can predispose to dissemination during dissection. Diagnostic ureteroscopy has therefore become a useful tool in the preoperative assessment. Biopsies can determine the tumour grade and guide the surgeon's choice of surgical approach.
authors.affiliation: Département d'Urologie, Institut Mutualiste Montsouris, Université Paris V, René Descartes, France. mroupret@club-internet.fr
authors.forename: Morgan
authors.initials: M
authors.lastname: Roupret
authors.forename: François
authors.initials: F
authors.lastname: Rozet
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Sanderson
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lesur
authors.forename: Dilermando
authors.initials: D
authors.lastname: Almeida
authors.forename: Justin D
authors.initials: JD
authors.lastname: Harmon
authors.forename: Eric
authors.initials: E
authors.lastname: Barret
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
authors.forename: Guy
authors.initials: G
authors.lastname: Vallancien
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D007682:Kidney Pelvis; D010535:Laparoscopy; D009392:Nephrectomy / Q000379:methods*; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000601:surgery*