Comparison between complete retroperitoneal laparoscopic radical nephroureterectomy and open nephroureterectomy

Abstract:

Objective：To compare the clinical efficacy of retroperitoneal laparoscopic radical nephroureterectomy and open nephro-ureterectomy in treating transitional cell carcinoma of the upper urinary tract. Methods：Forty-four cases of upper urinary tract transi－tional cell carcinoma were treated with radical nephroureterectomy and were divided into laparoscopy group（n=15） and open surgery group（n=29）. Patients in laparoscopy group underwent complete retroperitoneal laparoscopic nephroureterectomy while those in open surgery group underwent open nephroureterectomy. Operation time，intra-operative blood loss volume，post-operative painkiller appli－cation dosage and time，recovery time of intestinal function，time of getting out of bed，length of hospital stay and complications were compared and analyzed. All cases were followed up for 6-42 months，survival rates，incidences of bladder carcinoma recurrence and distant metastasis were recorded and compared. Results：Operations of both groups were successfully performed. Blood loss volume and application dosage of painkiller were fewer in laparoscopy group than in open surgery group （116.1±29.4） ml vs. （278.6±84.3） ml，（33.3±24.4） mg vs.（155.2±62.8） mg，P=0.000. Application time of painkiller and hospital stay were shorter in laparoscopy group than in open surgery group （0.7±0.5） d vs. （2.3±0.9） d，（8.7±1.6） d vs. （13.1±3.2） d，P=0.000. Time of getting out of bed was earlier in laparoscopy group than in open surgery group （2.1±0.5） d vs. （4.2±1.0） d，P=0.000. No significant difference was found between two groups in operation time （212.1±19.5） min vs. （251.7±24.2） min and recovery time of intestinal function （1.9±0.8） d vs. （2.9±0.8） d as well as in survival rates，postoperative complications，incidences of bladder carcinoma recurrence and distant metas－tasis during the follow-up period（P >0.05）. Conclusions：With the advantages of minimal invasion，complete retroperitoneal laparo－scopic radical nephroureterectomy conforms to the principles of oncology and should be widely applied as an ideal surgical treatment method for upper urinary tract transitional cell carcinoma.