Comparative study of ureteral stripping versus open ureterectomy for nephroureterectomy in patients with transitional carcinoma of the renal pelvis

Takashi Saika, Jun Nishiguchi, Tomoyasu Tsushima, Yasutomo Nasu, Atsushi Nagai, Yoshiyuki Miyaji, Yoshio Maki, Teruaki Akaeda, Michihisa Saegusa, Hiromi Kumon

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Abstract

Objectives To evaluate the clinical outcome of nephroureterectomy with endoscopically assisted transurethral ureteral stripping for transitional cell carcinoma of the renal pelvis in a comparative study. Methods Sixty patients with localized renal pelvic cancer were enrolled in a prospective comparative nonrandomized study. Of these, 28 patients underwent nephroureterectomy with endoscopically assisted transurethral ureteral stripping and 32 underwent conventional nephroureterectomy with a bladder cuff. Both short-term and long-term results were analyzed in this series. Results The operating time for patients with ureteral stripping was significantly shorter than for those with a standard two-incision nephroureterectomy (median 183 versus 250 minutes, P = 0.0231), and the amount of blood loss was significantly less (median 150 versus 390 mL, P = 0.0002). Intravesical recurrence was detected in 10 (35.7%) of the 28 patients with ureteral stripping, and the 1-year and 3-year recurrence-free rate was 68.0% and 57.7%, respectively. Seven patients treated by the standard two-incision nephroureterectomy (21.9%) experienced intravesical recurrence, with a 1-year and 3-year recurrence-free rate of 96.8% and 75.0%, respectively. The recurrence rate was significantly greater in the group with ureteral stripping (P = 0.0287). Conclusions Compared with conventional nephroureterectomy with a bladder cuff, nephroureterectomy with transurethral stripping is a minimally invasive procedure with a shorter operating time and less blood loss, but a statistically significantly greater intravesical recurrence rate. Greater consideration should be taken before selecting this procedure.

Original languageEnglish
Pages (from-to)848-852
Number of pages5
JournalUrology
Volume63
Issue number5
DOIs
Publication statusPublished - May 2004
Externally publishedYes

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Kidney Pelvis
Carcinoma
Recurrence
Urinary Bladder
Pelvic Neoplasms
Transitional Cell Carcinoma
Kidney Neoplasms

ASJC Scopus subject areas

  • Urology

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Comparative study of ureteral stripping versus open ureterectomy for nephroureterectomy in patients with transitional carcinoma of the renal pelvis. / Saika, Takashi; Nishiguchi, Jun; Tsushima, Tomoyasu; Nasu, Yasutomo; Nagai, Atsushi; Miyaji, Yoshiyuki; Maki, Yoshio; Akaeda, Teruaki; Saegusa, Michihisa; Kumon, Hiromi.

In: Urology, Vol. 63, No. 5, 05.2004, p. 848-852.

Research output: Contribution to journalArticle

Saika, T, Nishiguchi, J, Tsushima, T, Nasu, Y, Nagai, A, Miyaji, Y, Maki, Y, Akaeda, T, Saegusa, M & Kumon, H 2004, 'Comparative study of ureteral stripping versus open ureterectomy for nephroureterectomy in patients with transitional carcinoma of the renal pelvis', Urology, vol. 63, no. 5, pp. 848-852. https://doi.org/10.1016/j.urology.2003.12.003
Saika, Takashi ; Nishiguchi, Jun ; Tsushima, Tomoyasu ; Nasu, Yasutomo ; Nagai, Atsushi ; Miyaji, Yoshiyuki ; Maki, Yoshio ; Akaeda, Teruaki ; Saegusa, Michihisa ; Kumon, Hiromi. / Comparative study of ureteral stripping versus open ureterectomy for nephroureterectomy in patients with transitional carcinoma of the renal pelvis. In: Urology. 2004 ; Vol. 63, No. 5. pp. 848-852.
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abstract = "Objectives To evaluate the clinical outcome of nephroureterectomy with endoscopically assisted transurethral ureteral stripping for transitional cell carcinoma of the renal pelvis in a comparative study. Methods Sixty patients with localized renal pelvic cancer were enrolled in a prospective comparative nonrandomized study. Of these, 28 patients underwent nephroureterectomy with endoscopically assisted transurethral ureteral stripping and 32 underwent conventional nephroureterectomy with a bladder cuff. Both short-term and long-term results were analyzed in this series. Results The operating time for patients with ureteral stripping was significantly shorter than for those with a standard two-incision nephroureterectomy (median 183 versus 250 minutes, P = 0.0231), and the amount of blood loss was significantly less (median 150 versus 390 mL, P = 0.0002). Intravesical recurrence was detected in 10 (35.7{\%}) of the 28 patients with ureteral stripping, and the 1-year and 3-year recurrence-free rate was 68.0{\%} and 57.7{\%}, respectively. Seven patients treated by the standard two-incision nephroureterectomy (21.9{\%}) experienced intravesical recurrence, with a 1-year and 3-year recurrence-free rate of 96.8{\%} and 75.0{\%}, respectively. The recurrence rate was significantly greater in the group with ureteral stripping (P = 0.0287). Conclusions Compared with conventional nephroureterectomy with a bladder cuff, nephroureterectomy with transurethral stripping is a minimally invasive procedure with a shorter operating time and less blood loss, but a statistically significantly greater intravesical recurrence rate. Greater consideration should be taken before selecting this procedure.",
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AU - Saika, Takashi

AU - Nishiguchi, Jun

AU - Tsushima, Tomoyasu

AU - Nasu, Yasutomo

AU - Nagai, Atsushi

AU - Miyaji, Yoshiyuki

AU - Maki, Yoshio

AU - Akaeda, Teruaki

AU - Saegusa, Michihisa

AU - Kumon, Hiromi

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N2 - Objectives To evaluate the clinical outcome of nephroureterectomy with endoscopically assisted transurethral ureteral stripping for transitional cell carcinoma of the renal pelvis in a comparative study. Methods Sixty patients with localized renal pelvic cancer were enrolled in a prospective comparative nonrandomized study. Of these, 28 patients underwent nephroureterectomy with endoscopically assisted transurethral ureteral stripping and 32 underwent conventional nephroureterectomy with a bladder cuff. Both short-term and long-term results were analyzed in this series. Results The operating time for patients with ureteral stripping was significantly shorter than for those with a standard two-incision nephroureterectomy (median 183 versus 250 minutes, P = 0.0231), and the amount of blood loss was significantly less (median 150 versus 390 mL, P = 0.0002). Intravesical recurrence was detected in 10 (35.7%) of the 28 patients with ureteral stripping, and the 1-year and 3-year recurrence-free rate was 68.0% and 57.7%, respectively. Seven patients treated by the standard two-incision nephroureterectomy (21.9%) experienced intravesical recurrence, with a 1-year and 3-year recurrence-free rate of 96.8% and 75.0%, respectively. The recurrence rate was significantly greater in the group with ureteral stripping (P = 0.0287). Conclusions Compared with conventional nephroureterectomy with a bladder cuff, nephroureterectomy with transurethral stripping is a minimally invasive procedure with a shorter operating time and less blood loss, but a statistically significantly greater intravesical recurrence rate. Greater consideration should be taken before selecting this procedure.

AB - Objectives To evaluate the clinical outcome of nephroureterectomy with endoscopically assisted transurethral ureteral stripping for transitional cell carcinoma of the renal pelvis in a comparative study. Methods Sixty patients with localized renal pelvic cancer were enrolled in a prospective comparative nonrandomized study. Of these, 28 patients underwent nephroureterectomy with endoscopically assisted transurethral ureteral stripping and 32 underwent conventional nephroureterectomy with a bladder cuff. Both short-term and long-term results were analyzed in this series. Results The operating time for patients with ureteral stripping was significantly shorter than for those with a standard two-incision nephroureterectomy (median 183 versus 250 minutes, P = 0.0231), and the amount of blood loss was significantly less (median 150 versus 390 mL, P = 0.0002). Intravesical recurrence was detected in 10 (35.7%) of the 28 patients with ureteral stripping, and the 1-year and 3-year recurrence-free rate was 68.0% and 57.7%, respectively. Seven patients treated by the standard two-incision nephroureterectomy (21.9%) experienced intravesical recurrence, with a 1-year and 3-year recurrence-free rate of 96.8% and 75.0%, respectively. The recurrence rate was significantly greater in the group with ureteral stripping (P = 0.0287). Conclusions Compared with conventional nephroureterectomy with a bladder cuff, nephroureterectomy with transurethral stripping is a minimally invasive procedure with a shorter operating time and less blood loss, but a statistically significantly greater intravesical recurrence rate. Greater consideration should be taken before selecting this procedure.

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