Clinical Application Of Pure Transperitoneal Laparoscopic Nephroureterectomy In The Treatment Of Upper Tract Urothelial Carcinoma

Object:To compare and analyze the efficacy and safety of pure transperitoneal laparoscopic nephroureterectomy(PTLNU)and retroperitoneal laparoscopic nephroureterectomy combined with transurethral ureterostomy(RLNU)in the treatment of upper tract urothelial carcinoma to provide a reference for clinical treatment.Methods:Patients with urinary epithelial carcinoma of the upper urinary tract who were confirmed by pathology after surgery in our hospital from September 2017 to July 2019 were collected.41 cases were included according to the inclusion and exclusion criteria.21 patients underwent PTLNU,while 20 underwent RLNU.The ureteral bladder opening was purely resected by laporoscopic approach in PTLNU group while the RLNU group by transurethral resection.By comparing the age,gender,body mass index(BMI),tumor site,tumor size,operation time,intraoperative blood loss,postoperative exhaust time,postoperative hospitalization time,catheter indwelling time,analgesic using time and drainage tube indwelling time were analyzed and compared to provide information for the efficacy and safety of the two treatment methods.Results:There was no statistically significant difference in general clinical data such as age,gender,BMI,tumor location,tumor size between the two groups(P >0.05).There were statistically significant differences between the PTLNU group and the RLNU group in terms of surgical time,intraoperative blood loss,postoperative hospital stay,indwelling catheter time,and postoperative exhaust time(P <0.05).There were no significant differences in analgesic using time,postoperative complications,short-term oncology results,etc.Conclusion:Compare pure retroperitoneal laparoscopic nephroureterectomy(PTLNU)with laparoscopic nephroureterectomy combined with transurethral ureterectomy(RLNU),the intraoperative bleeding is less,the operation time,the postoperative hospital stay and the indwelling urethral catheterization are shorter in the former one,while the postoperative exhaust time is earlier in the latter one;as for short-term oncology and postoperative complications,there were no significant difference between two approaches.