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Erschienen in: Current Urology Reports 5/2016

01.05.2016 | Urothelial Cancer (A Sagalowsky, Section Editor)

Complications Following Radical Nephroureterectomy

verfasst von: Jay D. Raman, Syed M. Jafri

Erschienen in: Current Urology Reports | Ausgabe 5/2016

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Abstract

Radical nephroureterectomy (RNU) is the gold standard treatment strategy for bulky, high-grade, or muscle-invasive upper tract urothelial carcinoma (UTUC). Many patients with UTUC who require RNU are elderly, comorbid, and at risk for perioperative complications. Recognition of likelihood and extent of such complications guides preoperative counseling, decision-making process for major surgery, and perioperative care. A critical review of such data is essential, given the inevitable impact of complications on hospital duration, need for readmission, resource utilization, and costs associated with management.
Literatur
1.
Zurück zum Zitat Raman JD, Scherr DS. Management of patients with upper urinary tract transitional cell carcinoma. Nat Clin Pract Urol. 2007;4(8):432–43.CrossRefPubMed Raman JD, Scherr DS. Management of patients with upper urinary tract transitional cell carcinoma. Nat Clin Pract Urol. 2007;4(8):432–43.CrossRefPubMed
2.
Zurück zum Zitat Raman JD, Messer J, Sielatycki JA, Hollenbeak CS. Incidence and survival of patients with carcinoma of the ureter and renal pelvis in the USA, 1973-2005. BJU Int. 2011;107(7):1059–64.CrossRefPubMed Raman JD, Messer J, Sielatycki JA, Hollenbeak CS. Incidence and survival of patients with carcinoma of the ureter and renal pelvis in the USA, 1973-2005. BJU Int. 2011;107(7):1059–64.CrossRefPubMed
3.
Zurück zum Zitat Wein AJ, Kavoussi LR, Campbell MF. Campbell-Walsh urology/editor-in-chief, Alan J. Wein; [editors, Louis R. Kavoussi et al.]. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012. Wein AJ, Kavoussi LR, Campbell MF. Campbell-Walsh urology/editor-in-chief, Alan J. Wein; [editors, Louis R. Kavoussi et al.]. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012.
4.
Zurück zum Zitat Margulis V, Shariat SF, Matin SF, Kamat AM, Zigeuner R, Kikuchi E, et al. Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer. 2009;115(6):1224–33.CrossRefPubMed Margulis V, Shariat SF, Matin SF, Kamat AM, Zigeuner R, Kikuchi E, et al. Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer. 2009;115(6):1224–33.CrossRefPubMed
5.
Zurück zum Zitat Roupret M, Babjuk M, Comperat E, Zigeuner R, Sylvester R, Burger M, et al. European guidelines on upper tract urothelial carcinomas: 2013 update. Eur Urol. 2013;63(6):1059–71.CrossRefPubMed Roupret M, Babjuk M, Comperat E, Zigeuner R, Sylvester R, Burger M, et al. European guidelines on upper tract urothelial carcinomas: 2013 update. Eur Urol. 2013;63(6):1059–71.CrossRefPubMed
6.••
Zurück zum Zitat Lin YK, Deliere A, Lehman K, Harpster LE, Kaag MG, Raman JD. Critical analysis of 30 day complications following radical nephroureterectomy for upper tract urothelial carcinoma. Can J Urol. 2014;21(4):7369–73. A critical review of almost 100 consecutive RNU operations to define that the risk of complications following surgery is approximately 40 %. The principal risk factor for complication was poor performance status.PubMed Lin YK, Deliere A, Lehman K, Harpster LE, Kaag MG, Raman JD. Critical analysis of 30 day complications following radical nephroureterectomy for upper tract urothelial carcinoma. Can J Urol. 2014;21(4):7369–73. A critical review of almost 100 consecutive RNU operations to define that the risk of complications following surgery is approximately 40 %. The principal risk factor for complication was poor performance status.PubMed
7.
Zurück zum Zitat Rassweiler JJ, Schulze M, Marrero R, Frede T, Palou Redorta J, Bassi P. Laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma: is it better than open surgery? Eur Urol. 2004;46(6):690–7.CrossRefPubMed Rassweiler JJ, Schulze M, Marrero R, Frede T, Palou Redorta J, Bassi P. Laparoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma: is it better than open surgery? Eur Urol. 2004;46(6):690–7.CrossRefPubMed
8.•
Zurück zum Zitat Hanna N, Sun M, Trinh QD, Hansen J, Bianchi M, Montorsi F, et al. Propensity-score-matched comparison of perioperative outcomes between open and laparoscopic nephroureterectomy: a national series. Eur Urol. 2012;61(4):715–21. Nationwide inpatient sample (NIS) study with propensity-score matched analysis suggesting a lower complication rate for laparoscopic versus open nephroureterectomy.CrossRefPubMed Hanna N, Sun M, Trinh QD, Hansen J, Bianchi M, Montorsi F, et al. Propensity-score-matched comparison of perioperative outcomes between open and laparoscopic nephroureterectomy: a national series. Eur Urol. 2012;61(4):715–21. Nationwide inpatient sample (NIS) study with propensity-score matched analysis suggesting a lower complication rate for laparoscopic versus open nephroureterectomy.CrossRefPubMed
9.•
Zurück zum Zitat Ni S, Tao W, Chen Q, Liu L, Jiang H, Hu H, et al. Laparoscopic versus open nephroureterectomy for the treatment of upper urinary tract urothelial carcinoma: a systematic review and cumulative analysis of comparative studies. Eur Urol. 2012;61(6):1142–53. Systematic review of 21 studies comparing open and laparoscopic nephrouretectomy that indicates no significant difference in intraoperative, perioperative, and postoperative complications between approaches.CrossRefPubMed Ni S, Tao W, Chen Q, Liu L, Jiang H, Hu H, et al. Laparoscopic versus open nephroureterectomy for the treatment of upper urinary tract urothelial carcinoma: a systematic review and cumulative analysis of comparative studies. Eur Urol. 2012;61(6):1142–53. Systematic review of 21 studies comparing open and laparoscopic nephrouretectomy that indicates no significant difference in intraoperative, perioperative, and postoperative complications between approaches.CrossRefPubMed
10.
Zurück zum Zitat Sugihara T, Yasunaga H, Yu C, Horiguchi H, Nishimatsu H, Fushimi K, et al. Perioperative outcome comparisons between open and laparoscopic nephroureterectomy among a population-based cohort from 2010 to 2012. J Endourol Endourol Soc. 2015;29(7):770–6.CrossRef Sugihara T, Yasunaga H, Yu C, Horiguchi H, Nishimatsu H, Fushimi K, et al. Perioperative outcome comparisons between open and laparoscopic nephroureterectomy among a population-based cohort from 2010 to 2012. J Endourol Endourol Soc. 2015;29(7):770–6.CrossRef
11.••
Zurück zum Zitat Hanske J, Sanchez A, Schmid M, Meyer CP, Abdollah F, Feldman AS, et al. A comparison of 30-day perioperative outcomes in open versus minimally invasive nephroureterectomy for upper tract urothelial carcinoma: analysis of 896 patients from the American College of Surgeons-National Surgical Quality Improvement Program Database. J Endourol Endourol Soc. 2015;29(9):1052–8. A manuscript highlighting that MIRNU has similar overall complication rates compared to ORNU. MINU, however, was associated with a decreased risk of blood transfusions, thromboembolic events, re-intervention, and overall LOS compared to ONU.CrossRef Hanske J, Sanchez A, Schmid M, Meyer CP, Abdollah F, Feldman AS, et al. A comparison of 30-day perioperative outcomes in open versus minimally invasive nephroureterectomy for upper tract urothelial carcinoma: analysis of 896 patients from the American College of Surgeons-National Surgical Quality Improvement Program Database. J Endourol Endourol Soc. 2015;29(9):1052–8. A manuscript highlighting that MIRNU has similar overall complication rates compared to ORNU. MINU, however, was associated with a decreased risk of blood transfusions, thromboembolic events, re-intervention, and overall LOS compared to ONU.CrossRef
12.
Zurück zum Zitat Tinay I, Gelpi-Hammerschmidt F, Leow JJ, Allard CB, Rodriguez D, Wang Y, et al. Trends in utilization, perioperative outcomes and costs for nephroureterectomies in the management of upper tract urothelial carcinoma (UTUC): a 10-year population-based analysis. BJU Int. 2015. Tinay I, Gelpi-Hammerschmidt F, Leow JJ, Allard CB, Rodriguez D, Wang Y, et al. Trends in utilization, perioperative outcomes and costs for nephroureterectomies in the management of upper tract urothelial carcinoma (UTUC): a 10-year population-based analysis. BJU Int. 2015.
13.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Rajput MZ, Kamat AM, Clavell-Hernandez J, Siefker-Radtke AO, Grossman HB, Dinney CP, et al. Perioperative outcomes of laparoscopic radical nephroureterectomy and regional lymphadenectomy in patients with upper urinary tract urothelial carcinoma after neoadjuvant chemotherapy. Urology. 2011;78(1):61–7.CrossRefPubMedPubMedCentral Rajput MZ, Kamat AM, Clavell-Hernandez J, Siefker-Radtke AO, Grossman HB, Dinney CP, et al. Perioperative outcomes of laparoscopic radical nephroureterectomy and regional lymphadenectomy in patients with upper urinary tract urothelial carcinoma after neoadjuvant chemotherapy. Urology. 2011;78(1):61–7.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Raman JD, Lin YK, Kaag M, Atkinson T, Crispen P, Wille M, et al. High rates of advanced disease, complications, and decline of renal function after radical nephroureterectomy. Urol Oncol. 2014;32(1):47. e9-14.CrossRefPubMed Raman JD, Lin YK, Kaag M, Atkinson T, Crispen P, Wille M, et al. High rates of advanced disease, complications, and decline of renal function after radical nephroureterectomy. Urol Oncol. 2014;32(1):47. e9-14.CrossRefPubMed
16.••
Zurück zum Zitat Connolly SS, Rochester MA, Baus. Nephroureterectomy surgery in the UK in 2012: British Association of Urological Surgeons (BAUS) registry data. BJU Int. 2015;116(5):780–90. Population-based registry of perioperative outcomes following nephroureterectomy.CrossRefPubMed Connolly SS, Rochester MA, Baus. Nephroureterectomy surgery in the UK in 2012: British Association of Urological Surgeons (BAUS) registry data. BJU Int. 2015;116(5):780–90. Population-based registry of perioperative outcomes following nephroureterectomy.CrossRefPubMed
Metadaten
Titel
Complications Following Radical Nephroureterectomy
verfasst von
Jay D. Raman
Syed M. Jafri
Publikationsdatum
01.05.2016
Verlag
Springer US
Erschienen in
Current Urology Reports / Ausgabe 5/2016
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-016-0595-1

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