Clinical Research On Laparoscopic Retroperitoneal Surgery For Renal Pelvic Carcinoma

Objectives:To compare outcome and follow up of laparoscopic retroperitoneal nephroureterectomy with excision of cuff of bladder (LRPNUT-BCE) and open nephroureterectomy with excision of cuff of bladder (ONUT-BCE) in patients of renal pelvic transitional cell carcinoma.Methods:From July 2000 to February 2009, we have performed over 56 cases of nephroureterectomy with excision of cuff of bladder for renal pelvic transitional cell carcinoma. Out of these, patients undergoing LRPNUT-BCE and ONUT-BCE were categorized retrospectively into group A(31),and group B(25),respectively. The clinical data and follow-up data was recorded for two groups and analyzed statistically.Results:Age, gender, tumor size were comparable in both groups (LRPNUT-BCE vs.ONUT-BCE). The intraoperative bleeding loss (98.2±18.5)ml,the mean time to oral intake(33.6±8.8)h,time to ambulation (43.5±12.5)h, use of antalgesic (1.5±0.5)d, intravenous antibiotic (3.5±1.1)d, length of post operative hospital stay (6.5±1.2)d, (20.0±8.5)d convalescene of normal activities and incidence of complications with Group A were significantly superior to those with Group B (P<0.05);There were no differences in average operating time (150.2±13.0 vs 141.7±17.2min, P=0.659). Median follow-up was (36.6±16.0) and (38.0±16.7)months,there were no differences in the recurrence rate in two groups.Conclusions:laparoscopic retroperitoneal nephroureterectomy with excision of cuff of bladder (LRPNUT-BCE) can be used initially for renal pelvic transitional cell carcinoma, with equival entoncologic outcomes to open approaches while providing advantages of minimal invasion, less suffering and quicker recovery.