Section of Laparoscopic and Robotic Surgery, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA
Purpose of Review:
Laparoscopic radical nephroureterectomy (LNU) is being increasingly performed at several centers across the world. This review analyzes the published perioperative and oncologic outcomes of this procedure.
Laparoscopic radical nephroureterectomy (LNU) for upper tract TCC is performed pure laparoscopically (LNU) or hand-assisted (HALNU). The most debated issues for oncologic outcomes are management of the distal ureter and lymphadenectomy. LNU appears to have superior perioperative outcomes when compared to open surgery. Although long-term outcomes after LNU are limited, intermediate term oncologic outcomes are comparable to open nephroureterectomy (ONU), the reference standard.
Intermediate term oncologic outcomes for LNU compare well with ONU. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between LNU and open surgery is needed to define the role of these modalities in the current context.
Received Date: 28/2/2008 Revision Received Date: 2/4/2008 Acceptance Date: 12/4/2008 Electronic publication date: 29/4/2008
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