1.Comparison of ureteral terminal treatment in nephroureterectomy
Feng HAN ; Guofan DONG ; Yihan WANG ; Wenguang WANG
China Modern Doctor 2024;62(20):90-93,98
Objective To evaluate the clinical efficacy,safety and prognosis of patients with renal pelvis carcinoma and upper ureteral carcinoma treated by retroperitoneal laparoscopic radical nephroureterectomy.Whether there is a significant difference in the clinical efficacy,safety and prognosis of two different methods of ureteral terminal treatment(lower abdominal small incision and transurethral resection).Methods Analysis of the data from 108 patients with renal pelvis carcinoma or upper ureteral carcinoma,treated by nephroureterectomy at the first affiliated Hospital of Xinjiang Medical University from January 2012 to December 2022 was conducted.according to the different treatment of the end of the ureter,the patients were divided into two groups:lower abdominal small incision group(open group,n=58)and transurethral resection group(transurethral resection group,n=50).Patients in the open group underwent a retroperitoneal laparoscopic nephroureterectomy,along with a lower abdominal small incision ureterectomy,and those in the urethra group underwent a retroperitoneal laparoscopic nephroureterectomy and transurethral resection of the ureter.To gain a better understanding of the clinical data of the two groups,including basic data,operation time,intraoperative blood loss,postoperative hospital stay,and postoperative outcomes,a collection of data was made.recurrence,recurrence location and complications,a conclusion was drawn by statistical analysis.Results The open group's average operation time was(171±54)min,while the urethra group's was(141±37)min.However,no significant difference in intraoperative blood loss,postoperative hospital stay,recurrence rate,or postoperative complications was observed between the two groups.Conclusion Consequently,it is concluded that both methods of ureteral terminal treatment for renal pelvis and upper ureteral carcinoma are safe and dependable,with the transurethral resection operation time being shorter.at the same time,it did not increase the risk of postoperative recurrence and complications,intraoperative blood loss and postoperative hospital stay.
2.Factors influencing recurrence within two years after the first TURBT and risk prediction model for NMIBC
Yunze WANG ; Rong FAN ; Shiming CHEN ; Jianwei SUN ; Aliyar AIXANJIANG ; Guofan DONG ; Kulaisi ENEVAR ; Wenguang WANG
Journal of Modern Urology 2025;30(4):322-326
Objective: To analyze the risk factors of recurrence after transurethral resection of bladder tumor (TURBT) in patients with non-muscle-invasive bladder cancer (NMIBC),and establish a risk prediction model,so as to optimize the clinical detection and management of NMIBC. Methods: A total of 174 patients with initial diagnosis of NMIBC who underwent TURBT in the First Affiliated Hospital of Xinjiang Medical University during Jan.2020 and Oct.2022 were followed up for 24 months,and were then divided into the recurrence group (n=74) and non-recurrence group (n=100).After univariate analysis and multivariate logistic regression,risk factors of recurrence were identified,a nomogram was established,and the calibration curve was plotted,which was verified with receiver operator characteristic (ROC) curve. Results: The 2-year recurrence rate was 42.53%.Logistic regression showed high body mass index (BMI),poor differentiation,multiple tumors,and tumor diameter greater than 3 cm were risk factors of recurrence (P<0.05,OR≥1),while immediate postoperative intravesical instillation was a protective factor (P<0.05).The C-index of the nomogram was 0.893 (95%CI:0.851-0.938),the area of ROC curve (AUC) was 0.894 (95%CI:0.847-0.941),the sensitivity was 82.4%,and the specificity was 83.0%. Conclusion: The prediction model based on BMI,tumor stage,grade,number,diameter,and immediate postoperative intravesical instillation fits well and can provide reference for predicting the risk of tumor recurrence.