Two-micron thulium laser resection of the distal ureter and bladder cuff during nephroureterectomy for upper urinary tract urothelial carcinoma.
Identifieur interne : 000221 ( Main/Exploration ); précédent : 000220; suivant : 000222Two-micron thulium laser resection of the distal ureter and bladder cuff during nephroureterectomy for upper urinary tract urothelial carcinoma.
Auteurs : Kun Pang [République populaire de Chine] ; Shi-Bo Liu ; Hai-Bin Wei ; Jian Zhuo ; Mei-Li Li ; Shu-Jie Xia ; Xiao-Wen SunSource :
- Lasers in medical science [ 1435-604X ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Durée du séjour, Durée opératoire, Femelle, Humains, Mâle, Néphrectomie (), Période postopératoire, Récidive tumorale locale, Résultat thérapeutique, Sujet âgé, Thulium, Thérapie laser (), Thérapie laser (instrumentation), Tumeurs de l'uretère (), Tumeurs de l'uretère (anatomopathologie), Uretère (), Vessie urinaire (), Électrochirurgie (), Études rétrospectives.
- MESH :
- anatomopathologie : Tumeurs de l'uretère.
- Adulte d'âge moyen, Durée du séjour, Durée opératoire, Femelle, Humains, Mâle, Néphrectomie, Période postopératoire, Récidive tumorale locale, Résultat thérapeutique, Sujet âgé, Thulium, Thérapie laser, Tumeurs de l'uretère, Uretère, Vessie urinaire, Électrochirurgie, Études rétrospectives.
English descriptors
- KwdEn :
- Aged, Electrosurgery (methods), Female, Humans, Laser Therapy (instrumentation), Laser Therapy (methods), Length of Stay, Male, Middle Aged, Neoplasm Recurrence, Local, Nephrectomy (methods), Operative Time, Postoperative Period, Retrospective Studies, Thulium, Treatment Outcome, Ureter (surgery), Ureteral Neoplasms (pathology), Ureteral Neoplasms (surgery), Urinary Bladder (surgery).
- MESH :
- chemical : Thulium.
- instrumentation : Laser Therapy.
- methods : Electrosurgery, Laser Therapy, Nephrectomy.
- pathology : Ureteral Neoplasms.
- surgery : Ureter, Ureteral Neoplasms, Urinary Bladder.
- Aged, Female, Humans, Length of Stay, Male, Middle Aged, Neoplasm Recurrence, Local, Operative Time, Postoperative Period, Retrospective Studies, Treatment Outcome.
Abstract
The thulium laser (Tm-laser) technique has been used in the management of many urologic conditions. The present study aimed to evaluate the use of this technique for distal ureter and bladder cuff (DUBC) excision during nephroureterectomy for upper urinary tract urothelial carcinoma (UUT-UC). Fifty-eight patients with UUT-UC who underwent radical nephroureterectomy were included in this retrospective study. DUBC was managed by open excision in 24 cases, by transurethral electrosurgery in 17 cases, and by transurethral Tm-laser in 17 cases. Perioperative measures and oncologic outcomes were compared among the three groups. Furthermore, 11 human ureteral segments were collected to measure the burst pressure and show physical pressure tolerance, and six ureteral segments were assessed histologically to investigate the sealing effect. Operative time and hospital stay were significantly longer, and intraoperative blood loss was significantly greater in the open excision group than in the electrosurgery and Tm-laser groups (P < 0.05 for all). There were no significant differences in these parameters between the electrosurgery and Tm-laser groups. In addition, there were no significant differences in the incidences of bladder tumors and retroperitoneal recurrence of urothelial carcinoma among the three groups. The coagulation time and resection time were significantly shorter in the Tm-laser group than in the electrosurgery group. The mean burst pressure did not differ significantly between the tissues sealed by electrosurgery and by Tm-laser. Histopathological analyses showed that distal ureters were completely sealed by both electrosurgery and Tm-laser. The Tm-laser technique is superior to open excision and comparable to transurethral electrosurgery in the management of DUBC during nephroureterectomy for UUT-UC, offering an alternative treatment option for this condition.
DOI: 10.1007/s10103-013-1365-7
PubMed: 23793413
Affiliations:
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Le document en format XML
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The present study aimed to evaluate the use of this technique for distal ureter and bladder cuff (DUBC) excision during nephroureterectomy for upper urinary tract urothelial carcinoma (UUT-UC). Fifty-eight patients with UUT-UC who underwent radical nephroureterectomy were included in this retrospective study. DUBC was managed by open excision in 24 cases, by transurethral electrosurgery in 17 cases, and by transurethral Tm-laser in 17 cases. Perioperative measures and oncologic outcomes were compared among the three groups. Furthermore, 11 human ureteral segments were collected to measure the burst pressure and show physical pressure tolerance, and six ureteral segments were assessed histologically to investigate the sealing effect. Operative time and hospital stay were significantly longer, and intraoperative blood loss was significantly greater in the open excision group than in the electrosurgery and Tm-laser groups (P < 0.05 for all). There were no significant differences in these parameters between the electrosurgery and Tm-laser groups. In addition, there were no significant differences in the incidences of bladder tumors and retroperitoneal recurrence of urothelial carcinoma among the three groups. The coagulation time and resection time were significantly shorter in the Tm-laser group than in the electrosurgery group. The mean burst pressure did not differ significantly between the tissues sealed by electrosurgery and by Tm-laser. Histopathological analyses showed that distal ureters were completely sealed by both electrosurgery and Tm-laser. The Tm-laser technique is superior to open excision and comparable to transurethral electrosurgery in the management of DUBC during nephroureterectomy for UUT-UC, offering an alternative treatment option for this condition.</div></front></TEI><affiliations><list><country><li>République populaire de Chine</li></country></list><tree><noCountry><name sortKey="Li, Mei Li" sort="Li, Mei Li" uniqKey="Li M" first="Mei-Li" last="Li">Mei-Li Li</name><name sortKey="Liu, Shi Bo" sort="Liu, Shi Bo" uniqKey="Liu S" first="Shi-Bo" last="Liu">Shi-Bo Liu</name><name sortKey="Sun, Xiao Wen" sort="Sun, Xiao Wen" uniqKey="Sun X" first="Xiao-Wen" last="Sun">Xiao-Wen Sun</name><name sortKey="Wei, Hai Bin" sort="Wei, Hai Bin" uniqKey="Wei H" first="Hai-Bin" last="Wei">Hai-Bin Wei</name><name sortKey="Xia, Shu Jie" sort="Xia, Shu Jie" uniqKey="Xia S" first="Shu-Jie" last="Xia">Shu-Jie Xia</name><name sortKey="Zhuo, Jian" sort="Zhuo, Jian" uniqKey="Zhuo J" first="Jian" last="Zhuo">Jian Zhuo</name></noCountry><country name="République populaire de Chine"><noRegion><name sortKey="Pang, Kun" sort="Pang, Kun" uniqKey="Pang K" first="Kun" last="Pang">Kun Pang</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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