A novel one-position versus conventional surgical approach for the treatment of upper urinary tract urothelial carcinoma: a multicenter cohort study based in western China.

INTRODUCTION

Traditional radical nephroureterectomy (nRNU) requires repositioning the patient sequentially from the lateral decubitus to the supine position, necessitating a complex surgical workflow. To streamline the procedure, we performed the new entire RNU in a single surgical position by intraoperatively rotating the patient's orientation. This study aimed to evaluate the operational convenience and safety of the nRNU versus cRNU.

MATERIALS AND

METHODS

A controlled trial was conducted at 12 hospitals in western China. Patients undergoing nRNU or cRNU for UTUC between 2013 and 2024 were divided into nRNU group and cRNU group. Baseline features, perioperative and oncologic outcomes, were included.

RESULTS

221 patients were deemed eligible and were included in the study, of which 78 for cRNU group and 143 for nRNU group. Surgery procedure was finished smoothly without any serious intraoperative complications. The operative time and postoperative hospital stay in nRNU group were shorter than cRNU group [operative time: (214.62 ± 56.77) min vs. (232.05 ± 65.29) min, P = 0.040; postoperative hospital stay: 6 (5, 7) days vs. 7 (6, 8) days, P < 0.001]. However, with regard to indwelling time of the drainage tube, nRNU group required longer time. There were no differences in bladder recurrence and distant metastasis between the two groups.

CONCLUSIONS

Our findings demonstrate that operative time and postoperative hospital stay were moderately reduced in the nRNU group relative to the cRNU group. This implies that nRNU confers partial advantages through streamlined intraoperative work flow. Tumor outcomes showed no difference between the two groups; the safety of the two groups was comparable.