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Bladder recurrence of upper urinary tract cancer after laparoscopic surgery
Author(s) -
Kume Haruki,
Teramoto Shinji,
Tomita Kyoichi,
Nishimatsu Hiroaki,
Takahashi Satoru,
Takeuchi Takumi,
Ota Nobutaka,
Kitamura Tadaichi
Publication year - 2006
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20459
Subject(s) - medicine , laparoscopic surgery , open surgery , surgery , laparoscopy , risk factor , bladder cancer , urinary system , upper urinary tract , urology , cancer
Purpose We reviewed our cases to determine whether laparoscopic nephroureterectomy is a risk factor for the bladder recurrence. Materials and Methods From 1996 to 2003, 65 nephroureterectomies were performed: 47 by open and 18 by laparoscopic surgery. In 43 (28 by open, 15 by laparoscopic surgery), bladder cancer was not observed at the time of the operation. Two laparoscopic operations were converted to open surgery because of technical problems. The other 13 with laparoscopic and 28 with open surgery were enrolled into this study. Results Significantly higher recurrence rate was observed in laparoscopic cases (69.2%) than that in open cases (35.7%, P = 0.0484) by log rank test. However, the operation time required in laparoscopic surgery (371.5 ± 90.8 min) was significantly longer than that in the open surgery (229.9 ± 46.6 min, P < 0.0001). In multivariate analysis (Cox proportional hazards model), only the longer operation time (>250 min) was a significant variable ( P = 0.0305), and laparoscopic surgery in itself was not a significant risk factor ( P = 0.5011). Conclusions Although frequent bladder recurrence was observed in laparoscopic cases, the most important risk factor was the longer operation time. Technical improvements including shortening of operation time and earlier ureteral ligation may decrease the bladder recurrence. J. Surg. Oncol. 2006;93: 318–322. © 2006 Wiley‐Liss, Inc.