BERKELEY, CA (UroToday.com) - Because of its high rate of recurrence, radical nephroureterectomy (NU) with bladder-cuff excision has been the traditional treatment for upper tract urothelial carcinoma (UTUC). However, given the morbidity of nephrectomy and the risk of developing chronic kidney disease (CKD) or dialysis-dependent renal failure, as well as the risk of contralateral tumors, a nephron-sparing approach may be preferable in selected patients.
We present two cases of renal pelvic tumor measuring 2cm × 2cm and 3cm × 2cm, respectively, in either functional or anatomical solitary kidney, which were successfully treated by percutaneous nephroscopic resection using monopolar electrocautery.
The diagnosis was built by computed tomography of urinary tract (CTU) and positive result of urine cytology. The percutaneous nephrostomy puncture of the affected kidney was performed under both C-arm fluoroscopic and ultrasonic guidance, then the tract was dilated to 30 Fr. for tumor resection. After removal of the tumor, a 22 Fr. nephrostomy tube and 6 Fr. double-J stent were inserted for indwelling drainage.
In an effort to reduce the risk of tumor recurrence and progression, 80 mg of bacillus Calmette-Guérin (BCG) in 100 ml of diluents was administered weekly via intravesical instillation for topical therapy. Both patients were followed up with cytology and CTU. At 6 and 9 months, the patients remained free of recurrence in both collecting system and bladder, and maintained stable renal function. In addition, there was no evidence of metastatic disease.
Bo Yang as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Shahekou District, Dalian, Liaoning Province, China