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首页 > 中华医学杂志(英文版) >Total endoscopic nephroureterectomy for native kidney ipsilateral to transplanted kidney

Total endoscopic nephroureterectomy for native kidney ipsilateral to transplanted kidney

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Background From limited exposure with management of the native distal ureter ipsilateral to the transplanted kidney,we usually choose open nephroureterectomy (NU) or laparoscopic NU combined with an open approach in renal transplant (RTx) recipients.We herein describe our preliminary experience with total endoscopic NU with bladder cuff (BC) excision and evaluate its feasibility for RTx recipients.Methods From August 2008 to June 2011,eight RTx recipients underwent total endoscopic NU with BC excision for clinically presumed native upper urinary tract urothelial carcinoma (UUT-UC) ipsilateral to the transplanted kidney.Cystoscopic circumferential excision of the ipsilateral ureteral orifice with BC was followed by retroperitoneal laparoscopic NU using early ureteral ligation without primary BC closure.The intact specimen was removed through a 3-cm flank incision (an enlarged trocar site).Perioperative and pathological data and oncological outcomes were collected and analyzed.Results All endoscopic procedures were completed successfully without major complications and with open conversion.The mean estimated blood loss was 100 ml with no blood transfusion.The mean operating room time was 234.8 minutes,mean time to ambulation was 2.6 days,and mean hospital stay was 9.0 days.Pathological findings confirmed UUT-UC in seven recipients,two with bladder UC.During the mean 25.2-month follow-up,none of the recipients developed recurrence,while two developed contralateral UUT-UC after the first NU.Conclusion Total endoscopic NU with BC excision is technically feasible and safe for RTx recipients.

作 者 HOU Xiao-fei(Department of Urology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China);BI Hai(Department of Urology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China);MA Lu-lin(Department of Urology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China);ZHAO Lei(Department of Urology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China);WANG Guo-liang(Department of Urology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China);
刊 名 中华医学杂志(英文版)  2012年125卷21期 3827-3830页  科学引文索引(Science Citation Index)收录科学引文索引扩展版(SCI Expanded)收录美国国立医学图书馆Medline数据库收录美国生物学预评数据库(BIOSIS Previews)收录美国《化学文摘》(Chemical Abstracts)收录中国科技论文统计源期刊(中国科技核心期刊)收录
英文期刊名 Chinese Medical Journal
关键词 kidney transplantation urinary tract urothelial carcinoma nephroureterectomy endoscopic surgery
DOI号 10.3760/cma.j.issn.0366-6999.2012.21.015

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