Comparision Of Managements Of Distal Ureter In Radical Nephroureterectomy For Renal Pelvic Carcinoma

Objective:Summarize our experience of 26 cases, in order to discuss the management of distal ureter in radical operation of renal pelvic carcinoma, and the value of holmium laser.Methods:Open radical nephroureterectomy(I), ureteral intussusception(II), transurethral resection of ureteral orifice(III)were performed in 10,8 and 8 cases respectively. And holmium laser were used for the resection of ureteral orifice in 5 cases.Results:All oprations were completed with no severe complications, except an open radical nephroureterectomy case with injury of inferior vena cava. The mean operation time were 70,42.5and 55 minutes in group I,â…¡, III respectively. The mean time of catheterization were 10,11 and 8 days in group I, II, III. The mean time of indwelling drainage tube were 3.5,5,4days and the mean time of bowel function recovery were 4.5,5and 3 days respectively. The mean time of hospitalization after operation were 13.5,16.5and 9.5 days in group I, II, III. There were no significant difference in three groups except the operation time. But the transurethral resection of ureteral orifice was better in reducing invasion and recurrent rate. Conclusions:Transurethral resection of ureteral orifice by holmium laser was an effective minimal invasive procedure for radical nephroureterectomy, which may decrease patient's incision, reduce operation time, and consistent with the oncological principles.