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Robot-assisted nephroureterectomy for upper tract urothelial carcinoma—feasibility and complications : a single center experience

Liedberg, F. LU ; Abrahamsson, J. LU ; Bobjer, J. LU ; Gudjonsson, S. LU ; Löfgren, A. LU ; Nyberg, M. LU and Sörenby, A. LU (2022) In Scandinavian Journal of Urology 56(4). p.301-307
Abstract

Background: Robot-assisted nephroureterectomy (RANU) is the primary treatment for upper tract urothelial carcinoma (UTUC) at our hospital for patients with clinical stage less than T2, and for patients with invasive tumours, but unfit for major surgery. Objective: To assess peri-operative conditions and outcomes of RANU at our unit, and to evaluate the safety of the procedure. Methods: The medical records of all 166 patients undergoing RANU for suspected UTUC and followed for more than three months in a large university hospital in Sweden were reviewed retrospectively. After the exclusion of twenty patients because of previous cystectomy, simultaneous surgical procedure, or other tumour types than UTUC in the pathological report, 146... (More)

Background: Robot-assisted nephroureterectomy (RANU) is the primary treatment for upper tract urothelial carcinoma (UTUC) at our hospital for patients with clinical stage less than T2, and for patients with invasive tumours, but unfit for major surgery. Objective: To assess peri-operative conditions and outcomes of RANU at our unit, and to evaluate the safety of the procedure. Methods: The medical records of all 166 patients undergoing RANU for suspected UTUC and followed for more than three months in a large university hospital in Sweden were reviewed retrospectively. After the exclusion of twenty patients because of previous cystectomy, simultaneous surgical procedure, or other tumour types than UTUC in the pathological report, 146 patients remained for the analyses. The primary endpoint was complication rate according to Clavien-Dindo at 90 days. Secondary endpoints were perioperative bleeding, violation of oncological surgical principles, hospital stay, and re-admission within 90 days. Results: The median age was 75 [(Inter Quartile Range) IQR 70–80] years and 57% of the patients had an ASA score above 2. According to Clavien-Dindo, one patient had a grade 3 complication, and no patient had a grade 4–5 complication. The median blood loss was 50 (IQR 20–100) ml and the median hospital stay was 6 (IQR 5–7) days. Twelve patients were re-admitted to the hospital within 90 days (eight with urinary tract infection/haematuria, one with hematoma, and three with other diseases). Conclusion: Robot-assisted nephroureterectomy is a safe procedure for patients with upper tract urothelial carcinoma, with a low risk of major surgical complications.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
complications, nephroureterectomy, peri-operative outcome, robot-assisted surgery, Upper tract urothelial carcinoma
in
Scandinavian Journal of Urology
volume
56
issue
4
pages
301 - 307
publisher
Taylor & Francis
external identifiers
  • scopus:85132837639
  • pmid:35736556
ISSN
2168-1805
DOI
10.1080/21681805.2022.2091018
language
English
LU publication?
yes
id
2d802eb4-de44-4bfb-9438-433bc9f4259c
date added to LUP
2022-09-23 13:02:24
date last changed
2024-02-14 13:36:32
@article{2d802eb4-de44-4bfb-9438-433bc9f4259c,
  abstract     = {{<p>Background: Robot-assisted nephroureterectomy (RANU) is the primary treatment for upper tract urothelial carcinoma (UTUC) at our hospital for patients with clinical stage less than T2, and for patients with invasive tumours, but unfit for major surgery. Objective: To assess peri-operative conditions and outcomes of RANU at our unit, and to evaluate the safety of the procedure. Methods: The medical records of all 166 patients undergoing RANU for suspected UTUC and followed for more than three months in a large university hospital in Sweden were reviewed retrospectively. After the exclusion of twenty patients because of previous cystectomy, simultaneous surgical procedure, or other tumour types than UTUC in the pathological report, 146 patients remained for the analyses. The primary endpoint was complication rate according to Clavien-Dindo at 90 days. Secondary endpoints were perioperative bleeding, violation of oncological surgical principles, hospital stay, and re-admission within 90 days. Results: The median age was 75 [(Inter Quartile Range) IQR 70–80] years and 57% of the patients had an ASA score above 2. According to Clavien-Dindo, one patient had a grade 3 complication, and no patient had a grade 4–5 complication. The median blood loss was 50 (IQR 20–100) ml and the median hospital stay was 6 (IQR 5–7) days. Twelve patients were re-admitted to the hospital within 90 days (eight with urinary tract infection/haematuria, one with hematoma, and three with other diseases). Conclusion: Robot-assisted nephroureterectomy is a safe procedure for patients with upper tract urothelial carcinoma, with a low risk of major surgical complications.</p>}},
  author       = {{Liedberg, F. and Abrahamsson, J. and Bobjer, J. and Gudjonsson, S. and Löfgren, A. and Nyberg, M. and Sörenby, A.}},
  issn         = {{2168-1805}},
  keywords     = {{complications; nephroureterectomy; peri-operative outcome; robot-assisted surgery; Upper tract urothelial carcinoma}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{301--307}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{Robot-assisted nephroureterectomy for upper tract urothelial carcinoma—feasibility and complications : a single center experience}},
  url          = {{http://dx.doi.org/10.1080/21681805.2022.2091018}},
  doi          = {{10.1080/21681805.2022.2091018}},
  volume       = {{56}},
  year         = {{2022}},
}