Laparoscopic Nephroureterectomy for Upper Tract Transitional Cell Carcinoma: Comparison of Laparoscopic and Open Surgery

Abstract

ObjectivesWe made a comparative study of laparoscopic nephroureterectomy (LNU) and standard open surgery (ONU) for upper urinary tract transitional cell carcinoma. Methods and methodsFrom July 2000 to February 2005, 49 patients underwent total nephroureterectomy for upper tract transitional cell carcinoma at Osaka University Medical Hospital. Of the 49 patients, twenty-five were treated with LNU, and twenty-four with ONU. Each group of cases was reviewed with respect to operative time, complications and postoperative convalescence. ResultsThe average operative time of the LNU and ONU group was 305.9min (range 190–480) and 271.2min (range 135–480) respectively, and the average blood loss was 321.5ml (80–1370) and 557.7ml (range 100–1730), respectively. The average time until ambulation after LNU and ONU was 2.2 days (range 1–3) and 4.0 days (range 3–5), respectively. No major postoperative complications were observed in either group. ConclusionONU still represents the gold standard for the management of upper tract transitional cell carcinoma; however, for low stage cases, LNU offers the advantages of minimally invasive surgery.