title: Total retroperitoneal laparoscopic nephroureterectomy with bladder-cuff resection for upper urinary tract transitional cell carcinoma.
abstract: BACKGROUND
  Open nephroureterectomy (ONU) and bladder cuff resection (ONU-BCR) has been the gold standard of surgical treatment for upper urinary tract transitional cell carcinoma (UUT-TCC). The aim of this study is to introduce a modified total retroperitoneal laparoscopic nephroureterectomy (LNU) with bladder-cuff resection (LNU-BCR) method for treating UUT-TCC and compare its clinical efficacy with ONU-BCR.
  
  
  METHODS
  Sixty-five patients with UUT-TCC, who underwent ONU-BCR (n = 36) or LNU-BCR (n = 29) between January 2008 and June 2012, were analyzed in this retrospective study. Perioperative data as well as incidence of disease recurrence at the primary site or distant metastasis was compared in patients with at least 6 months follow-up.
  
  
  RESULTS
  As compared with patients with ONU-BCR, the patients with LNU-BCR had significantly shorter operative time, lower estimated blood loss, shorter time to oral intake, lower analgesic dose, shorter duration of analgesic use, shorter duration of incision drainage tube, shorter time to ambulation out of bed and reduced postoperative hospital stay (all, p < .05). No significant difference in postoperative complications or incidence of bladder carcinoma recurrence and distant metastasis during the follow-up period was observed.
  
  
  CONCLUSIONS
  The modified LNU-BCR represents an effective and safe alternative technique to ONU-BCR with the advantages of reduced invasiveness, bleeding and hospitalization.
authors.affiliation: Department of Urology, Center of Nephrology, The Second Affiliated Hospital of the Third Military Medical University, Chongqing, China.
authors.forename: Zhenqiang
authors.initials: Z
authors.lastname: Fang
authors.forename: Longkun
authors.initials: L
authors.lastname: Li
authors.forename: Xiangwei
authors.initials: X
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Weisheng
authors.initials: W
authors.lastname: Jia
authors.forename: Fan
authors.initials: F
authors.lastname: He
authors.forename: Chongxing
authors.initials: C
authors.lastname: Shen
authors.forename: Gang
authors.initials: G
authors.lastname: Ye
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009399:Nephrons / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014571:Urologic Neoplasms / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: humans; laparoscopy; nephrectomy; transitional cell carcinoma; urinary bladder; urologic surgical procedures