Wu Fei, Wang Zhen, Sun Liang, Zhang Meixia, Ning Hao, Niu Zhihong, Lyu Jiaju, Gao Dexuan
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250014, China.
Department of Urology, Jinan Third People's Hospital, Jinan, Shandong 250101, China.
Bladder (San Franc). 2025 Jul 3;12(3):e21200049. doi: 10.14440/bladder.2025.0007. eCollection 2025.
Radical nephroureterectomy (RNU) with bladder cuff excision represents the standard treatment for high-risk upper tract urothelial carcinoma (UTUC).
This study aimed to evaluate the safety, feasibility, and clinical outcomes of a modified laparoscopic single-position RNU plus bladder cuff resection.
This retrospective analysis examined patients diagnosed with UTUC who underwent RNU between May 2022 and July 2024. Participants were divided into three groups: Group A (39 patients) underwent the modified technique, Group B (38 patients) received standard laparoscopic nephroureterectomy with bladder cuff resection, and Group C (27 patients) had laparoscopic nephroureterectomy with an additional lower abdominal incision for bladder cuff resection. We compared baseline characteristics, intraoperative variables, and post-operative outcomes among the groups.
A total of 104 patients were included and analyzed. Their baseline characteristics showed no significant differences among groups (>0.05). Group A experienced a significantly shorter operative time and earlier ureteral catheter removal compared to Groups B and C (<0.05). Intraoperative blood loss, gastrointestinal recovery time, and length of hospital stay were comparable between Groups A and B, but the results in the two groups were more favorable against Group C (<0.05). Follow-up revealed no significant differences in tumor recurrence and metastasis rates across groups (>0.05).
The modified laparoscopic single-position RNU in combination with bladder cuff resection is a safe and effective minimally invasive approach for UTUC, offering advantages like reduced operative time, early catheter removal, and enhanced patient recovery, supporting its broader clinical application.
根治性肾输尿管切除术（RNU）联合膀胱袖口切除术是高危上尿路尿路上皮癌（UTUC）的标准治疗方法。
本研究旨在评估改良腹腔镜单体位RNU联合膀胱袖口切除术的安全性、可行性和临床疗效。
本回顾性分析研究了2022年5月至2024年7月期间诊断为UTUC并接受RNU的患者。参与者分为三组：A组（39例患者）接受改良技术，B组（38例患者）接受标准腹腔镜肾输尿管切除术联合膀胱袖口切除术，C组（27例患者）接受腹腔镜肾输尿管切除术并额外在下腹部做切口进行膀胱袖口切除术。我们比较了各组的基线特征、术中变量和术后结果。
共纳入104例患者并进行分析。他们的基线特征在各组之间无显著差异（>0.05）。与B组和C组相比，A组的手术时间明显更短，输尿管导管拔除更早（<0.05）。A组和B组的术中失血量、胃肠道恢复时间和住院时间相当，但这两组的结果均优于C组（<0.05）。随访显示各组之间的肿瘤复发和转移率无显著差异（>0.05）。
改良腹腔镜单体位RNU联合膀胱袖口切除术是一种安全有效的UTUC微创方法，具有手术时间缩短、导管早期拔除和患者恢复加快等优点，支持其更广泛的临床应用。
