title: Intravesical and transperitoneal laparoscopy in the management of tumor in the residual ureter.
abstract: The occurrence of tumor in the residual ureter after an incomplete nephroureterectomy required by a tumor of renal collecting system is an uncommon but a well described situation. The recommended treatment in this situation is the radical excision of the remaining ureter, being the open technique the most used approach. The aim of this video is to demonstrate a new approach using intravesical and transperitoneal laparoscopy to remove the residual ureter following the oncological concepts. A 67 year-old male patient underwent an incomplete open right radical nephroureterectomy for a transitional cell carcinoma of the renal collecting system. After 16 months, the cystoscopy diagnostic revealed a recurrence of it in the residual ureter. An intravesical approach followed by a transperitoneal laparoscopy has removed the remaining ureter. Operative time was 110 minutes, blood loss 100 mL, the patient was discharged on the first postoperative day and the Foley catheter was removed on the seventh one. Pathological examination revealed low grade transitional cell carcinoma and free surgical margins, no recurrence was observed after six months. To our knowledge, this is the first treatment description of a tumor in the residual ureter with these techniques. This approach can be a minimal invasive alternative in this unusual situation.
authors.affiliation: Department of Urology, Cruz Vermelha Hospital and Vita Batel Hospital, Curitiba, Brazil. anibal@awbranco.com.br
authors.forename: Anibal Wood
authors.initials: AW
authors.lastname: Branco
authors.forename: Luciano
authors.initials: L
authors.lastname: Stunitz
authors.forename: Sandro
authors.initials: S
authors.lastname: Nichele
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Douat
authors.forename: Murilo
authors.initials: M
authors.lastname: Luiz
authors.forename: Lucas
authors.initials: L
authors.lastname: Tha Nassif
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000601:surgery*