| Autor: |
Coman, R. A., Crivăț, S., Turturică, S., Pop, T., Labo, S., Chiujdea, S., Coste, B., Maghiar, T., Petruț, B. |
| Předmět: |
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| Zdroj: |
Romanian Journal of Urology; 2021, Vol. 20 Issue 3, p49-53, 5p |
| Abstrakt: |
Introduction and Objectives. Since the first laparoscopic radical nephroureterectomy performed by Clayman in 1991, the surgical technique has improved and the indications of laparoscopic radical nephroureterectomy can be extended to locally advanced diseases . The first radical cystectomy performed for bladder cancer was reported by Sanchez de Badajoz in 1995. Laparoscopic approach has been increasingly used as an alternative to open radical cystectomy with promising functional and oncological results. Materials and Methods. We present a case of laparoscopic radical nephroureterectomy and anterior pelvic exenteration with extended lymphadenectomy in a patient with high-grade upper urinary tract carcinoma, recurrent highgrade non-muscle invasive bladder cancer, and a previous left open nephroureterectomy with bladder cuff removal and lymphadenectomy. The partial exenteration and the extended lymphadenectomy were successfully performed with laparoscopic approach in this particular case of high-grade urothelial carcinoma. Results. The final histopathology exam revealed high-grade urothelial carcinoma of the renal pelvis pT3N0MxL0V0R0, urothelial carcinoma non-invasive of the ureter pTaG2, urothelial carcinoma microinvasive pT1G1 of the urinary bladder with squamous cell carcinoma in situ pTis, squamous cell carcinoma in situ of the cervix. We discuss the operative steps and the techniques performed to optimize the oncological results in the laparoscopic approach for high risk urothelial carcinoma. Conclusions. Laparoscopic radical nephroureterectomy accompanying radical cystectomy, hysterectomy, and bilateral salpingo-oophorectomy with extended lymphadenectomy for multifocal high-risk urothelial carcinoma is oncologically safe, technically feasible, and can safely be performed for urinary system exenteration in patients with multifocal urothelial tumors, even though the patient will be anephric at the end of the surgery with need for hemodialysis. [ABSTRACT FROM AUTHOR] |
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