Laparoscopic versus Open Nephroureterectomy: Perioperative and Oncologic Outcomes from a Randomised Prospective Study

Giuseppe Simone, Rocco Papalia, Salvatore Guaglianone, Mariaconsiglia Ferriero, Costantino Leonardo, Ester Forastiere, Michele Gallucci

Research output: Contribution to journalArticle

Abstract

Background: Laparoscopic nephroureterectomy (LNU) is increasingly being used instead of open nephroureterectomy (ONU) for the treatment of urothelial carcinoma (UC) of the upper urinary tract (UUT), but the evidence of equal oncologic effectiveness is still lacking. Objective: To present perioperative and oncologic results from a prospective randomised study comparing ONU and LNU. Design, setting, and participants: Eighty patients with nonmetastatic UUT UC and without previous history of UC were enrolled. Of those, 40 patients (group A) randomly received ONU and 40 patients (group B) randomly received LNU. Interventions: ONU was performed through a flank incision with a lower quadrant incision to allow excision of a bladder cuff. Transperitoneal LNU was performed with a four-trocar technique, and bladder cuff was detached with a 10-mm LigaSure device. Measurements: Perioperative data were compared with the student t test. Bladder tumour-free survival (BTFS), metastasis-free survival (MFS), and cancer-specific survival (CSS) curves for both groups were compared with the log-rank test before and after stratifying patients for pT category and tumour grade. Results and limitations: Operative times were comparable, while mean blood loss and mean time to discharge were significantly lower in group B (both p values

Original languageEnglish
Pages (from-to)520-526
Number of pages7
JournalEuropean Urology
Volume56
Issue number3
DOIs
Publication statusPublished - Sep 2009

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Keywords

  • Laparoscopic nephroureterectomy
  • Open nephroureterectomy
  • Urothelial carcinomas of the upper urinary tract

ASJC Scopus subject areas

  • Urology

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