[Role of retroperitoneal laparoscopic nephroureterectomy in the current treatment of upper urinary tract urothelial carcinoma].
BACKGROUND
Nowadays, the standard treatment for upper tract transitional cell carcinoma is open nephroureterectomy, by double lumbar and iliac approach, with peri-meat bladder cuff excision. Since the first laparoscopic nephroureterectomy was performed, several surgical teams were interested by this approach for the treatment of the upper tract transitional cell carcinoma.


OBJECTIVE
To plead for retro-peritoneoscopic nephroureterectomy and to assess the surgical indications.


METHODS
Were analyzed the results of the recent published series on nephroureterectomy for upper urinary tract transitional cell carcinoma. Were included studies on conventional, laparoscopic and retro-peritoneoscopic nephroureterectomy, with at least 10 cases, published after 2000.


RESULTS
The advantages of retro-peritoneoscopic nephroureterectomy are: minimum blood loss, reduced analgesic intake, a shorter hospital stay and a faster return to previous activities, lower rate of intra- or postoperative complications compared with trans-peritoneal laparoscopy or conventional surgery. With a proper case selection the oncologic safety of the retro-peritoneoscopy is equivalent with open surgery.


CONCLUSIONS
On short term, retro-peritoneoscopic approach shows similar oncological outcome with other techniques. Retroperitoneal laparoscopic nephroureterectomy is a viable alternative to conventional or trans-peritoneoscopic procedure, with clear cut benefits for the patient. Retro-peritoneoscopy is associated with a low morbidity.
Burghelea
C
C
Institutul Clinic de Urologie si Transplant Renal Cluj-Napoca, Romania.
Ghervan
L
L
Bărbos
A
A
Lucan
V C
VC
Elec
F
F
Moga
S
S
Bologa
F
F
Constantin
L
L
Iacob
G
G
Partiu
A
A
D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D007682:Kidney Pelvis; D010535:Laparoscopy / Q000379:methods; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods; D013520:Urologic Surgical Procedures / Q000379:methods