Robot-assisted nephroureterectomy for upper tract urothelial carcinoma: Initial experience

Shun-Fa Hung^a, †, Wei-Che Wu^a, †, Shiu-Dong Chung^{a, b}

^a Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
^b Department of Urology, School of Medicine, Tzu Chi University, Hualien, Taiwan

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Abstract
Objective

To report our early experience with robot-assisted laparoscopic nephroureterectomy (RANU) for upper tract urothelial carcinoma (UTUC).

Materials and methods

Four consecutive patients with a diagnosis of renal pelvic or ureteral urothelial carcinoma underwent RANU. We performed RANU by redocking the robot after the nephrectomy without repositioning the patient for excision of the distal ureter and bladder cuff.

Results

Three women and one man with a mean age of 72.3 years and mean body mass index (BMI) of 24.25 kg/m2 underwent RANU for right-sided renal pelvic or ureteral urothelial carcinoma. The mean operative time was 495 minutes (range 390–540 minutes), estimated blood loss was 52.5 mL (range 10–100 mL), and mean hospital stay was 5.5 days. Pathology data revealed all specimens were high grade carcinoma with one specimen each staged Ta, T1, T2, and T3. After a mean follow-up of 14.25 months (range 12–18 months), no intravesical recurrence developed in the bladder, and no patients developed distant metastasis.

Conclusion

Our early experience showed that RANU is a safe and feasible minimally invasive procedure for UTUC.

Keywords
Kidney; Laparoscopy; Robot; Ureter; Urothelial carcinoma