Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2007
[Comparison of the oncological results of laparoscopic and open surgical total nephroureterectomy].
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Müller Brice, Braud Guillaume, Tillou Xavier, Karam Georges, Bouchot Olivier, Rigaud Jérôme
Аннотация
OBJECTIVE: To analyse the medium-term oncological results of total nephroureterectomy for upper tract urothelial tumour according to the surgical approach: laparoscopy or open surgery.
MATERIAL: Retrospective study including 38 consecutive patients undergoing total nephroureterectomy for upper tract urothelial tumour in our department. Patients were classified into 2 groups according to the surgical approach: Group 1 (19 patients) laparoscopic release of the kidney +/- distal ureter and Group 2 (19 patients) open surgery of the kidney and ureter.
RESULTS: The two groups were comparable in terms of clinical context and histology. The mean follow-up was 27 +/- 22 months (range: 3-77 months). During this follow-up, 9 patients (23.7%) died from progression of their urothelial tumour. A local recurrence was observed in 6 cases (15.8%), a bladder recurrence was observed in 14 cases (36.8%) and metastatic recurrence was observed in 4 cases (11.4%). The operative technique (laparoscopy versus open surgery) did not influence overall survival (p = 0.5339), or local (p = 0.4503), bladder (p = 0.8224) or metastatic (p = 0.8932) recurrence-free survival.
CONCLUSION: The medium-term oncological results oflaparoscopic total nephroureterectomy for upper tract urothelial tumour were comparable to those of open surgery.
MATERIAL: Retrospective study including 38 consecutive patients undergoing total nephroureterectomy for upper tract urothelial tumour in our department. Patients were classified into 2 groups according to the surgical approach: Group 1 (19 patients) laparoscopic release of the kidney +/- distal ureter and Group 2 (19 patients) open surgery of the kidney and ureter.
RESULTS: The two groups were comparable in terms of clinical context and histology. The mean follow-up was 27 +/- 22 months (range: 3-77 months). During this follow-up, 9 patients (23.7%) died from progression of their urothelial tumour. A local recurrence was observed in 6 cases (15.8%), a bladder recurrence was observed in 14 cases (36.8%) and metastatic recurrence was observed in 4 cases (11.4%). The operative technique (laparoscopy versus open surgery) did not influence overall survival (p = 0.5339), or local (p = 0.4503), bladder (p = 0.8224) or metastatic (p = 0.8932) recurrence-free survival.
CONCLUSION: The medium-term oncological results oflaparoscopic total nephroureterectomy for upper tract urothelial tumour were comparable to those of open surgery.