AI Article Synopsis
- Upper tract urothelial carcinoma (UTUC) is a serious condition affecting the urinary system, with debates on the best minimally invasive surgical techniques, specifically robotic-assisted nephroureterectomy (RANU) vs. laparoscopic nephroureterectomy (LNU).
- A systematic review was conducted comparing RANU and LNU, analyzing outcomes such as recurrence rates and mortality.
- Findings showed a higher mortality rate with LNU compared to RANU (1.8% vs. 1.1%), but results were inconsistent and further research is needed to determine the best surgical approach and its long-term outcomes.
Article Abstract
Background: Upper tract urothelial carcinoma (UTUC) is the malignant transformation of urothelial cells, from the renal calyces to the ureteral orifices. While the benefits of minimally invasive nephroureterectomy over their open counterpart have been established, the optimal technique remains a debate. We aimed to assess current evidence in the literature and compare outcomes between robotic-assisted (RANU) and laparoscopic nephroureterectomy (LNU).
Methods: A systematic review of the literature was performed for studies comparing RANU and LNU for bladder cancer. Outcome measurements were recurrence rates (local and distal), positive margins, positive lymph node yield and perioperative outcomes. Meta-analysis was performed using .
Results: Our results demonstrate a significantly higher mortality rate in patients undergoing laparoscopic nephroureterectomy when compared with the robotic-assisted approach for the treatment of UTUC (1.8% vs. 1.1%, = 0.008); however, these results were inconsistent on sensitivity analysis and should therefore be interpreted with caution. No significant difference was observed for other outcomes.
Conclusion: The ideal approach to minimally invasive radical nephroureterectomy remains undetermined. Future research, ideally prospective randomised studies, should focus on long-term outcomes, in particular recurrence, recurrence-free survival, overall survival and the correlation between surgical technique and survival.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10071076 | PMC |
| http://dx.doi.org/10.1002/bco2.208 | DOI Listing |
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Article Synopsis
- Urological surgeons often face challenges in treating patients with simultaneous double cancers of the urinary tract, with limited previous reports on effective treatment strategies.
- A case involving a 73-year-old man demonstrated successful management of contralateral renal cell carcinoma and ureteral carcinoma through laparoscopic and robot-assisted surgeries, along with targeted drug therapy.
- The approach resulted in the preservation of renal function and avoided the need for dialysis while maintaining anticancer benefits.
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