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V48 Nephroureterectomy with primary endoscopic approach of the intramural ureter using bipolar plasma vaporization
V48 - Nephroureterectomy with primary endoscopic approach of the intramural ureter usi... Page 1 of 1
eV48 Nephroureterectomy with primary endoscopic approach of the intramural ureter using bipolar plasma vaporization Geavlete P.A., Georgescu D.A., Multescu D.R., Geavlete B.F. St John Emergency Clinical Hospital, Dept. of Urology, Bucharest, Romania INTRODUCTION & OBJECTIVES: Nefroureterectomy with perimeatal cystectomy is the gold standard in the treatment of urothelial upper urinary-tract carcinoma (UUTC). Ureteral endoscopic surgery was proposed as a complementary first step in nephroureterectomy in order to obviate the low abdominal incision. Our goal was to establish the value of a novel method of endoscopic distal ureteral management in one step nephroureterectomy for UUTC: pluck technique using bipolar plasma vaporization. MATERIAL & METHODS: In the last two years, 62 nephroureterectomies with endoscopic distal ureteral approach were performed for UUTC (pTa in 23 cases, pT1 in 18 cases, pT2 in 12 cases, pT3 in 9 cases). The tumor was pyelocaliceal in 44 cases, ureteral in 16 cases, and both ureteral and pyelocaliceal in 2 cases. All these patients underwent “pluck” transurethral detachment of the intramural ureter. The follow-up was performed by cystoscopy with urinary cytology, ultrasonography and intravenous urography. The mean follow-up was 18 months (range 8 to 33 months). RESULTS: All procedures were completed successfully. The complication rate was 4.8%: 3 cases of hematuria, one imposing endoscopic approach and other two treated conservatively. During follow-up, 7 patients had bladder recurrences, 1 had renal fossa tumors and 2 had secondary lymph-node invasion. The diseasespecific mortality rate was 4.8%. CONCLUSIONS: The endoscopic approach of the terminal ureter with bipolar plasma vaporization as part of one-step nephroureterectomy is a safe, facile and effective method offering good oncological results.
file://F:\RamShankar\April\04-05-12\Cip\Sour\V48.html
4/7/2012
eV48 Nephroureterectomy with primary endoscopic approach of the intramural ureter using bipolar plasma vaporization Geavlete P.A., Georgescu D.A., Multescu D.R., Geavlete B.F. St John Emergency Clinical Hospital, Dept. of Urology, Bucharest, Romania INTRODUCTION & OBJECTIVES: Nefroureterectomy with perimeatal cystectomy is the gold standard in the treatment of urothelial upper urinary-tract carcinoma (UUTC). Ureteral endoscopic surgery was proposed as a complementary first step in nephroureterectomy in order to obviate the low abdominal incision. Our goal was to establish the value of a novel method of endoscopic distal ureteral management in one step nephroureterectomy for UUTC: pluck technique using bipolar plasma vaporization. MATERIAL & METHODS: In the last two years, 62 nephroureterectomies with endoscopic distal ureteral approach were performed for UUTC (pTa in 23 cases, pT1 in 18 cases, pT2 in 12 cases, pT3 in 9 cases). The tumor was pyelocaliceal in 44 cases, ureteral in 16 cases, and both ureteral and pyelocaliceal in 2 cases. All these patients underwent “pluck” transurethral detachment of the intramural ureter. The follow-up was performed by cystoscopy with urinary cytology, ultrasonography and intravenous urography. The mean follow-up was 18 months (range 8 to 33 months). RESULTS: All procedures were completed successfully. The complication rate was 4.8%: 3 cases of hematuria, one imposing endoscopic approach and other two treated conservatively. During follow-up, 7 patients had bladder recurrences, 1 had renal fossa tumors and 2 had secondary lymph-node invasion. The diseasespecific mortality rate was 4.8%. CONCLUSIONS: The endoscopic approach of the terminal ureter with bipolar plasma vaporization as part of one-step nephroureterectomy is a safe, facile and effective method offering good oncological results.
file://F:\RamShankar\April\04-05-12\Cip\Sour\V48.html
4/7/2012