Organ-preserving surgery for the upper urinary tract malignancy

Abstract

The results of organ-preserving interventions are analyzed in 12 patients (7 males and 5 females) with neoplasms of the renal pelvis and ureter. Endoscopic operations were performed in 4 patients with the normally functioning contralateral kidney and in one patient with the single kidney. Early complications developed in 2 of the 12 patients and were infectious and inflammatory. The mean duration of endoscopic surgery was 32.8±4.9 min; intraoperative blood loss is 83.0±15.3 ml; the duration of open surgery averaged 157.2±29.7 min and intraoperative blood loss was 1930±69.3 ml. After 4 years of a follow-up, the frequency of tumor relapse was 40%; 5-year survival was 80%. Thus, in patients with upper urinary tract neoplasms, organ-preserving operations are a justifiable alternative to nephroureterectomy with urinary bladder resection and most reasonable in uni- and bilateral renal tumor. Urinary tract endoscopic examination assessing the possibilities of freely manipulating an endoscope in the ureteral lumen and renal cavitary system for biopsy of a tumor and its further removal is a major and determining factor in defining indications for this type of intervention.