Comparing Oncological Outcomes and Surgical Complications of Hand-Assisted, Laparoscopic and Robotic Nephroureterectomy for Upper Tract Urothelial Carcinoma

• DOI: 10.3389/fonc.2021.731460
• Publication Date: 2021-10-04T20:17:29Z
• Authors: Ching-Chia Li; Chao-Hsiang Chang; Chi-Ping Huang; Jian-Hua Hong; Chao-Yuan Huang; I-Hsuan Alan Chen; Jen-Tai Lin; Chi-Wen Lo; Chih-Chin Yu; Jen-Shu Tseng; Wun-Rong Lin; Wei-Che Wu; Shiu-Dong Chung; Thomas Y. Hsueh; Allen W. Chiu; Yung-Tai Chen; Shin-Hong Chen; Yuan-Hong Jiang; Yao-Chou Tsai; Bing-Juin Chiang; Wei Yu Lin; Yeong-Chin Jou; Chia-Chang Wu; Hsiang-Ying Lee; Hsin-Chih Yeh
• Keywords: Ileus

This study aimed to compare the oncological outcomes and surgical complications of patients with upper tract urothelial carcinoma (UTUC) treated different minimally invasive techniques for nephroureterectomy.From updated data Taiwan UTUC Collaboration Group, a total 3,333 were identified. After excluding ineligible cases, we retrospectively included 1,340 from 15 institutions who received hand-assisted laparoscopic nephroureterectomy (HALNU), (LNU) or robotic (RNU) between 2001 2021. Kaplan-Meier estimator Cox proportional hazards model used analyze survival outcomes, binary logistic regression was selected risks postoperative approaches.Among enrolled patients, 741, 458 141 HALNU, LNU RNU, respectively. Compared RNU (41.1%) (32.5%), rate lymph node dissection in HALNU lowest (17.4%). In both univariate analysis, type surgery significantly associated overall cancer-specific survival. The statistical significance methods on remained multivariate where undergoing appeared have worst (p = 0.007) 0.047) rates among three groups. all analyses, approach not related bladder recurrence. addition, longer hospital stay 0.002), had highest risk major Clavien-Dindo 0.011), paralytic ileus 0.012), end-stage renal disease <0.001).Minimally can be safe feasible. We proved that compared group, groups better fewer complications. It is crucial uphold strict principles sophisticated technique improve outcomes. Further prospective studies are needed validate our findings.