title: Is transureteroureterostomy performed during multi-organ resection for non-urothelial malignancy safe and effective?
abstract: BACKGROUND
  Multi-organ resection in patients with non-urothelial cancer may include segmental ureteral resection. The resulting ureteral defect can be reconstructed with a transureteroureterostomy (TUU); however, whether TUU is safe and effective in this patient group remains unclear.
  
  
  OBJECTIVE
  In the current retrospective analysis, we evaluated renal function before and after complex multi-organ resection that included TUU to determine whether TUU is safe and effective.
  
  
  METHODS
  We retrospectively reviewed the charts of patients who underwent TUU between 1995 and 2011. Renal imaging studies performed before and after TUU were used to determine whether hydronephrosis was present in either kidney. Kidney function was assessed by measuring serum creatinine levels and calculating the estimated glomerular filtration rate (eGFR) before and after TUU.
  
  
  RESULTS
  Twelve patients underwent TUU during multiorgan resection. Median follow-up time was 15 months. Three patients with cancer recurrence involving the TUU developed progressive hydronephrosis. Serum creatinine levels did not increase more than 0.5 mg/dl in any patient. Kidney function as assessed by eGFR was maintained in all patients (until the time of recurrence in the three patients with recurrence affecting the TUU).
  
  
  CONCLUSIONS
  TUU during multi-organ resection for non-urothelial malignancy is safe and effective. Long-term renal function is maintained in the majority of patients.
authors.affiliation: Department of Urology, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA. pisters@marshall.edu
authors.forename: Phillip W
authors.initials: PW
authors.lastname: Pisters
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Pettaway
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.forename: Surena F
authors.initials: SF
authors.lastname: Matin
authors.forename: John F
authors.initials: JF
authors.lastname: Ward
authors.forename: Dan
authors.initials: D
authors.lastname: Leibovici
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002648:Child; D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome; D014513:Ureter / Q000503:physiopathology / Q000601:surgery*; D014519:Ureterostomy
chemical_list: D015415:Biomarkers; D003404:Creatinine