title: A new 2-micrometer continuous wave laser method for management of the distal ureter in retroperitoneal laparoscopic nephroureterectomy.
abstract: OBJECTIVE
  Retroperitoneal laparoscopic nephroureterectomy (LNU) is a classic technique for the treatment of patients with urothelial cancer of the upper urinary tract. Management of the distal ureter in patients undergoing this procedure remains controversial, however. We evaluated a new method involving cystoscopic sleeve resection of the distal ureter using a 2-μm continuous wave laser before LNU.
  
  
  METHODS
  LNU was performed in 38 patients at our hospital between January 2008 and January 2012. The distal end of the ureter was managed by using a 2-μm continuous wave laser to evaporate and excise the ureteral orifice and bladder cuff. A standard technique was applied to keep the ureter intact. The ureter was dissected to the entrance of the bladder, and the distal ureter was easily detached from the bladder.
  
  
  RESULTS
  The distal ureter was excised completely in all cases using this new technique. The average operative time was 2.4 hours, and the average blood loss was 69.4 mL. At 1 year after surgery, the cause-specific survival rate of the patients was 100%, the bladder recurrence-free rate was 89%, and the extravesical recurrence-free rate was 100%.
  
  
  CONCLUSIONS
  For managing the distal ureter during LNU, the new technique described proved to be a simple, safe, and minimally invasive method.
authors.affiliation: 1 Department of Urology, PLA General Hospital , Beijing, China .
authors.forename: Gang
authors.initials: G
authors.lastname: Guo
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.forename: Jun
authors.initials: J
authors.lastname: Dong
authors.forename: Zhou
authors.initials: Z
authors.lastname: Zhenhong
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D003558:Cystoscopy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D007682:Kidney Pelvis; D010535:Laparoscopy / Q000379:methods; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000601:surgery*