Management of distal ureter and bladder cuff at the time of nephroureterectomy: surgical techniques and predictors of outcome

Future Oncol. 2019 Jul;15(20):2385-2393. doi: 10.2217/fon-2019-0064. Epub 2019 Jun 25.

Abstract

Open radical nephroureterectomy (NU) with removal of the ureter and bladder cuff is the 'gold standard' in the treatment of high-grade urothelial cancers of the upper urinary tract. A salient issue is the management of the distal ureter and bladder cuff at time of surgery. Which technique confers superior oncologic benefit is of particular interest since this disease process is notoriously plagued with high intravesical recurrence rates. Although open radical NU is the 'gold standard', the maturation of minimally invasive surgery formidably challenges approaches considered 'gold standard'. We thus sought to critically review the literature comparing perioperative and oncologic outcomes in the approaches used to manage the distal ureter and bladder cuff in patients undergoing radical NU.

Keywords: distal ureter and bladder cuff; radical nephroureterectomy; upper tract urothelial carcinoma.

Publication types

  • Review

MeSH terms

  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / surgery*
  • Humans
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / prevention & control*
  • Nephroureterectomy / methods*
  • Prognosis
  • Treatment Outcome
  • Ureter / pathology
  • Ureter / surgery
  • Ureteral Neoplasms / pathology
  • Ureteral Neoplasms / surgery*
  • Urinary Bladder / pathology
  • Urinary Bladder / surgery