The surgical technique and efficacy of a novel pure retroperitoneoscopic extravesical bladder cuff excision without intraoperative repositioning for upper tract urothelial carcinoma.

To evaluate the feasibility, effectiveness and therapeutic outcomes of a novel pure retroperitoneoscopic extravesical bladder cuff excision (PREBE) in patients with upper tract urothelial carcinoma (UTUC), a retrospectively comparative study between PREBE and traditional laparoscopic nephroureterectomy (TLNU) was done in a single center. We retrospectively evaluated 72 patients diagnosed with UTUC at our hospital from January 2022 to January 2024. The patients who underwent TLNU (n = 35) and PREBE (n = 37) were consecutively enrolled. The kidney and bladder cuff were retroperitoneoscopically dissected and the bladder was repaired with needle sutures under retroperitoneoscopic in the PREBE group. Demographic, perioperative, and follow-up data were collected and compared between the two groups. Both procedures were performed effectively in 72 patients without converting to open surgery. The PREBE group exhibited shorter mean operative time (P < 0.01), less mean estimated blood loss (EBL) (P < 0.01), shorter median drainage tube removal time, shorter median first postoperative defecation (FPD) time (P < 0.01) and shorter median postoperative hospital stay (P < 0.01). However, there was no statistical difference in postoperative pathological results or in the incidence of intravesical recurrence between the two groups. The mean follow-up time was 13.8 months for the PREBE group and 14.4 months for the TLNU group. The PREBE is a safe and effective treatment for patients with UTUC, avoiding intraoperative patient repositioning while offering better perioperative outcomes to those of traditional techniques.