A comparison of the clinical outcome between open and hand-assisted laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma

Thomas Y. Hsueh, Yi Hsiu Huang, Wen-Hsiang Chiou, Kun Hung Shen, Ying Huei Lee

Research output: Contribution to journalShort survey

33 Citations (Scopus)

Abstract

OBJECTIVE: To report the surgical outcome of retroperitoneoscopic hand-assisted laparoscopic nephroureterectomy (LNU) with bladder cuff excision for upper urinary tract transitional cell carcinoma (TCC), and to compare the outcome with that of the open procedure (ONU). PATIENTS AND METHODS: From January 1998 to January 2003, 145 patients with upper urinary tract TCC were enrolled in the study; 87 had ONU and 58 retroperitoneoscopic hand-assisted LNU. The specimens were reviewed by experienced pathologists to confirm the pathological stage. Operative duration, intraoperative blood loss, bowel recovery, analgesic use, hospital stay and time to convalescence were compared for both groups. The Mann-Whitney U-test and Fisher's exact test were used for statistical analysis. RESULTS: The mean follow-up for ONU and LNU was 35.1 and 16.0 months, the mean operative duration 230.2 and 259.1 min (P = 0.006), the mean blood loss 747.3 and 408.9 mL (P <0.001), the mean duration of Foley catheterization 6.8 and 5.1 days (P <0.001), and the hospital stay 12.6 and 9.3 days (P <0.001). The bladder recurrence rate 2 years after surgery was 9.1% for ONU and 8.6% for LNU (P = 0.23); the local recurrence rate during the follow-up was 3.4% and none, respectively (P = 0.35). CONCLUSION: Although LNU took longer than ONU the intraoperative bleeding and hospital stay were better than for ONU. Both procedures have statistically comparable bladder recurrence and local recurrence rates.

Original languageEnglish
Pages (from-to)798-801
Number of pages4
JournalBJU International
Volume94
Issue number6
DOIs
Publication statusPublished - Oct 2004

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Transitional Cell Carcinoma
Urinary Tract
Hand
Recurrence
Length of Stay
Urinary Bladder
Urinary Catheterization
Nonparametric Statistics
Analgesics
Hemorrhage

Keywords

  • Laparoscopy
  • Nephroureterectomy
  • Outcome
  • Recurrence
  • TCC

ASJC Scopus subject areas

  • Urology

Cite this

A comparison of the clinical outcome between open and hand-assisted laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma. / Hsueh, Thomas Y.; Huang, Yi Hsiu; Chiou, Wen-Hsiang; Shen, Kun Hung; Lee, Ying Huei.

In: BJU International, Vol. 94, No. 6, 10.2004, p. 798-801.

Research output: Contribution to journalShort survey

Hsueh, Thomas Y. ; Huang, Yi Hsiu ; Chiou, Wen-Hsiang ; Shen, Kun Hung ; Lee, Ying Huei. / A comparison of the clinical outcome between open and hand-assisted laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma. In: BJU International. 2004 ; Vol. 94, No. 6. pp. 798-801.
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abstract = "OBJECTIVE: To report the surgical outcome of retroperitoneoscopic hand-assisted laparoscopic nephroureterectomy (LNU) with bladder cuff excision for upper urinary tract transitional cell carcinoma (TCC), and to compare the outcome with that of the open procedure (ONU). PATIENTS AND METHODS: From January 1998 to January 2003, 145 patients with upper urinary tract TCC were enrolled in the study; 87 had ONU and 58 retroperitoneoscopic hand-assisted LNU. The specimens were reviewed by experienced pathologists to confirm the pathological stage. Operative duration, intraoperative blood loss, bowel recovery, analgesic use, hospital stay and time to convalescence were compared for both groups. The Mann-Whitney U-test and Fisher's exact test were used for statistical analysis. RESULTS: The mean follow-up for ONU and LNU was 35.1 and 16.0 months, the mean operative duration 230.2 and 259.1 min (P = 0.006), the mean blood loss 747.3 and 408.9 mL (P <0.001), the mean duration of Foley catheterization 6.8 and 5.1 days (P <0.001), and the hospital stay 12.6 and 9.3 days (P <0.001). The bladder recurrence rate 2 years after surgery was 9.1{\%} for ONU and 8.6{\%} for LNU (P = 0.23); the local recurrence rate during the follow-up was 3.4{\%} and none, respectively (P = 0.35). CONCLUSION: Although LNU took longer than ONU the intraoperative bleeding and hospital stay were better than for ONU. Both procedures have statistically comparable bladder recurrence and local recurrence rates.",
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N2 - OBJECTIVE: To report the surgical outcome of retroperitoneoscopic hand-assisted laparoscopic nephroureterectomy (LNU) with bladder cuff excision for upper urinary tract transitional cell carcinoma (TCC), and to compare the outcome with that of the open procedure (ONU). PATIENTS AND METHODS: From January 1998 to January 2003, 145 patients with upper urinary tract TCC were enrolled in the study; 87 had ONU and 58 retroperitoneoscopic hand-assisted LNU. The specimens were reviewed by experienced pathologists to confirm the pathological stage. Operative duration, intraoperative blood loss, bowel recovery, analgesic use, hospital stay and time to convalescence were compared for both groups. The Mann-Whitney U-test and Fisher's exact test were used for statistical analysis. RESULTS: The mean follow-up for ONU and LNU was 35.1 and 16.0 months, the mean operative duration 230.2 and 259.1 min (P = 0.006), the mean blood loss 747.3 and 408.9 mL (P <0.001), the mean duration of Foley catheterization 6.8 and 5.1 days (P <0.001), and the hospital stay 12.6 and 9.3 days (P <0.001). The bladder recurrence rate 2 years after surgery was 9.1% for ONU and 8.6% for LNU (P = 0.23); the local recurrence rate during the follow-up was 3.4% and none, respectively (P = 0.35). CONCLUSION: Although LNU took longer than ONU the intraoperative bleeding and hospital stay were better than for ONU. Both procedures have statistically comparable bladder recurrence and local recurrence rates.

AB - OBJECTIVE: To report the surgical outcome of retroperitoneoscopic hand-assisted laparoscopic nephroureterectomy (LNU) with bladder cuff excision for upper urinary tract transitional cell carcinoma (TCC), and to compare the outcome with that of the open procedure (ONU). PATIENTS AND METHODS: From January 1998 to January 2003, 145 patients with upper urinary tract TCC were enrolled in the study; 87 had ONU and 58 retroperitoneoscopic hand-assisted LNU. The specimens were reviewed by experienced pathologists to confirm the pathological stage. Operative duration, intraoperative blood loss, bowel recovery, analgesic use, hospital stay and time to convalescence were compared for both groups. The Mann-Whitney U-test and Fisher's exact test were used for statistical analysis. RESULTS: The mean follow-up for ONU and LNU was 35.1 and 16.0 months, the mean operative duration 230.2 and 259.1 min (P = 0.006), the mean blood loss 747.3 and 408.9 mL (P <0.001), the mean duration of Foley catheterization 6.8 and 5.1 days (P <0.001), and the hospital stay 12.6 and 9.3 days (P <0.001). The bladder recurrence rate 2 years after surgery was 9.1% for ONU and 8.6% for LNU (P = 0.23); the local recurrence rate during the follow-up was 3.4% and none, respectively (P = 0.35). CONCLUSION: Although LNU took longer than ONU the intraoperative bleeding and hospital stay were better than for ONU. Both procedures have statistically comparable bladder recurrence and local recurrence rates.

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