Abstract
The treatment of upper urinary tract transitional cell carcinoma (UT-TCC) in single-kidney patients requires the radical removal of cancer, but also, when feasible, the preservation of the continuity of the urinary tract by various surgical techniques. In case of wide resections during ureteral surgery, a ureteral replacement could be advocated. In the literature, the cecal appendix has rarely been used as a ureteral substitute, moreover in benign pathological conditions, showing encouraging early results. The positive functional and oncological outcomes obtained after a lengthy follow-up in a single-kidney patient with UT-TCC treated by ureteral resection and appendix interposition confirm the viability of this surgical option.
Highlights
The cecal appendix has long been used in urologic surgery as a continent catheterization way for the bladder or urinary reservoirs, literature reports on its use as a ureteral substitute are rare, especially with relation to the sparing treatment of upper urinary tract transitional cell carcinoma (UT-TCC)
We report our experience with a single case out of 237 submitted to surgery for UT-TCC at our department
In spite of all these advantages, very few reports can be found in the literature, with only two of them related to patients affected by UT-TCC[9,10], due to the high prevalence of appendicectomized patients and the incidence of anomalous or pathological appendixes, especially among elderly patients[11]
Summary
Alessandro Antonelli*, Danilo Zani, Paolo Dotti, Luigi Tralce, Claudio Simeone, and Sergio Cosciani Cunico. Received January 5, 2005; Revised March 5, 2005; Accepted March 13, 2005; Published April 5, 2005. The treatment of upper urinary tract transitional cell carcinoma (UT-TCC) in single-kidney patients requires the radical removal of cancer, and, when feasible, the preservation of the continuity of the urinary tract by various surgical techniques. In case of wide resections during ureteral surgery, a ureteral replacement could be advocated. The cecal appendix has rarely been used as a ureteral substitute, in benign pathological conditions, showing encouraging early results. The positive functional and oncological outcomes obtained after a lengthy follow-up in a singlekidney patient with UT-TCC treated by ureteral resection and appendix interposition confirm the viability of this surgical option
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