Laparoscopic nephroureterectomy for native upper tract urothelial carcinoma in renal transplant recipients
10.3760/cma.j.issn.0254-1785.2012.01.007
- VernacularTitle:腹腔镜手术治疗肾移植后自体上尿路上皮癌九例
- Author:
Diandong YANG
;
Zhenli GAO
;
Chunhua LIN
;
Shengqiang YU
;
Fengchun WAN
;
Dongfu LIU
;
Ke WANG
;
Jitao WU
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Urologic neoplasms;
Laparoscopy
- From:
Chinese Journal of Organ Transplantation
2012;33(1):25-27
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the clinical outcome of laparoscopic nephroureterectomy (LUNT) for native upper tract urothelial carcinoma (UC) in renal transplant (RT) recipients.Methods We conducted a retrospective analysis on 1130 RT recipients,and 9 patients (0.8％,9/1130) with native upper tract UC were identified. UC was confirmed pathologically in the 9 patients,including 3 cases of unilateral ureter tumor (2 on the right,and 1 on the left),4 cases of unilateral renal pelvis tumor (2 on the right,2 on the left),1 case of bilateral ureter tumor and 1 case of tumor in the right ureter and left kidney.Females predominated (8/9) in the 9 patients with upper tract UC.The patients with left upper urinary tract cancer underwent LUNT using a retroperitoneal approach with a technique of transurethral circumcision of the ureteral orifice.The patients with right upper urinary tract cancer were subjected to nephroureterctomy with ureterectomy and bladder cuff excision by complete laparascopy through a transperitoneal approach. Immunosuppressive protocol conversion from calcineurin inhibitors to sirolimus was performed on all cases. Results In the 9 patients,11 LUNTs were performed successfully without conversion to open surgery.The follow-up period was from 6 to 48 months. One patient died of lung metastasis at 8th month after tumor excision,and 1 patient displayed ductal cancer of the left breast at 7th month after LNUT.Another seven patients showed no evidence of disease during the follow-up period with normal renal function.ConclusionOur present clinical experience suggested that LNUT for the native upper tract cancer in renal transplant recipients is feasible,safe,and effective.
