Stripping technique for endoscopic management of distal ureter during nephroureterectomy: Experience of 32 procedures
| Autor: | Thierry Dayma, Michaël Peyromaure, Bertrand Giovansili, Marc Zerbib, Djillali Saighi, Bernard Debré |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Urology medicine.medical_treatment Nephrectomy Neoplasm Seeding Ureter Internal medicine Ureteroscopy medicine Carcinoma Humans Aged Retrospective Studies Upper urinary tract Aged 80 and over Carcinoma Transitional Cell medicine.diagnostic_test Ureteral Neoplasms business.industry Length of Stay Middle Aged medicine.disease Kidney Neoplasms Surgery Endoscopy Catheter Treatment Outcome medicine.anatomical_structure Cuff Carcinoma Squamous Cell Female Neoplasm Recurrence Local Urinary Catheterization business |
| Zdroj: | Urology. 64:448-452 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2004.04.080 |
| Popis: | Objectives To assess the results of the stripping technique for endoscopic management of the distal ureter during nephroureterectomy. Methods Since 1995, 32 patients have undergone open nephroureterectomy involving stripping of the distal ureter for upper urinary tract carcinoma. After endoscopic placement of a Chevassu ureteral catheter, nephrectomy was performed using a lumbotomy approach. The catheter tip was tied to the top of the ureteral extremity. At the end of the intervention, the catheter was pulled out transurethrally to intussuscept the distal ureter. Endoscopic resection through the bladder muscular wall was performed around the everted ureteral orifice, then the distal ureter was stripped and removed with a bladder cuff. Results The mean operative time was 180 minutes, and the mean blood loss was 220 mL. The stripping failed in 6 patients (18.7%), requiring an iliac incision. The reasons for failure were a retained ureter in 5 cases and ureteral breakage in 1 case. The mean duration of urethral catheterization was 5 days, and the mean hospital stay was 8 days. The complication rate was 3.1%. At a median follow-up of 35.2 months, 9 patients (28.1%) had experienced recurrence: 6 with superficial bladder tumors, 2 with renal fossa recurrence, and 1 with asynchronous liver metastases. The disease-specific mortality rate was 9.4%. Conclusions These results confirm that the stripping technique for endoscopic management of the distal ureter during open nephroureterectomy is a simple and safe procedure. |
| Databáze: | OpenAIRE |
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