Abstract
BackgroundTo report Taiwan’s experience in robot-assisted laparoscopic nephroureterectomy (RANU) for upper tract urothelial carcinoma (UTUC).MethodsTwenty patients with a diagnosis of renal pelvic or ureteral urothelial carcinoma underwent RANU at three medical centers. We performed RANU by re-docking the robot after the nephrectomy with or without repositioning for excision of the distal ureter and bladder cuff.ResultsFrom November 2010 to July 2013, a total of 20 patients with a mean age of 70.1 +/- 9.9 years (range 43 to 92 years) and mean body mass index (BMI) of 22.9 +/-3.8 kg/m2 underwent RANU for renal pelvic or ureteral urothelial carcinoma. Mean operative time was 251.6 +/- 126.7 minutes (range 110 to 540 minutes), estimated blood loss was 50.0 +/- 42.9 mL (range 10 to 200 mL), and mean length of hospital stay was 6.7 +/- 2.4 days (range 4 to 12 days). Pathology data revealed 19 high and one low-grade urothelial carcinoma and staged Ta for three, T1 for five, T2 for five and T3 for seven. With a mean follow-up of 14.7 months (range 2 to 34 months), three intravesical recurrences developed in the bladder, and four of them also developed metastatic disease.ConclusionsThe TRUST early experience showed that RANU is a safe and feasible minimally invasive procedure for UTUC.
Highlights
To report Taiwan’s experience in robot-assisted laparoscopic nephroureterectomy (RANU) for upper tract urothelial carcinoma (UTUC)
Laparoscopic nephroureterectomy (LNU) has been thought as a feasible technique for treating UTUC since Clayman et al reported the first case of LNU in 1991 [1]
Six men and fourteen women consecutive patients had received RANU, the patients were not repositioned after the nephrectomy, the robot was re-docked for excision of the distal ureter and bladder cuff
Summary
To report Taiwan’s experience in robot-assisted laparoscopic nephroureterectomy (RANU) for upper tract urothelial carcinoma (UTUC). The standard treatment of upper tract urothelial carcinoma (UTUC) is open nephroureterectomy (NU) with ipsilateral bladder-cuff excision. Laparoscopic nephroureterectomy (LNU) has been thought as a feasible technique for treating UTUC since Clayman et al reported the first case of LNU in 1991 [1]. In Taiwan, as many as approximately 10% to 21% of all UCs were UTUC, and the incidence of UTUC was greater than in other reports in the world [2,3]. Aristolochic acid, which is a component of Aristolochia herbal remedies and widely used in traditional Chinese multi-institutional experience by re-docking the robot without repositioning of the patient
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