Distal Ureter Management During Nephroureterectomy: Evidence from a Systematic Review and Cumulative Analysis

Journal of Endourology
Su-Min LeeOmar M Aboumarzouk

Abstract

Standard of care in upper tract urothelial cancer is nephroureterectomy with bladder cuff excision (BCE). However, alternative techniques such as transurethral incision/resection have been used to simplify distal ureterectomy. The optimum strategy is unclear, and current guidelines do not specify a gold standard technique. The objective of this study was to perform a systematic review of the literature, to compare BCE and transurethral distal ureter methods. A Cochrane and PRISMA-guided systematic literature search was conducted on English language articles from January 2000 to present, reporting on centers' experience with either BCE or transurethral distal ureterectomy. A cumulative meta-analysis comparison between the two procedures was performed. Primary outcome was intravesical recurrence. Secondary outcomes were local/distant recurrence, surgical margins, and disease-specific mortality (DSM). Groups were compared using chi-square analysis. In total, 66 studies were included after excluding 1795. BCE and transurethral groups contained 6130 and 1183 patients, respectively. Mean/median age ranged from 57.5 to 75.2 years, and follow-up from 6.1 to 78 months. Level of evidence was low, with high risk of bias and small sample s...Continue Reading

References

Jun 30, 2005·International Journal of Urology : Official Journal of the Japanese Urological Association·Mutsuo HayashiTakuya Okutani
Jun 15, 2006·International Journal of Urology : Official Journal of the Japanese Urological Association·Takatsugu OkegawaEiji Higashihara
Nov 7, 2006·European Urology·Alexander TsivianA Ami Sidi
Oct 19, 2007·Journal of Endourology·Petrişor GeavleteVictor Mirciulescu
Oct 19, 2007·Journal of Endourology·Frederico R RomeroThomas W Jarrett
Jun 22, 2011·Journal of Endourology·Chad R RitchJaime Landman
May 15, 2012·European Urology·Evanguelos XylinasUNKNOWN Upper Tract Urothelial Carcinoma Collaboration
Oct 11, 2012·TheScientificWorldJournal·Stilianos GiannakopoulosStavros Touloupidis
May 9, 2013·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Angela GillanGhulam Nabi

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Citations

Nov 28, 2019·World Journal of Urology·Alessandro VecciaRiccardo Autorino
Jul 28, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Danielle Whiting, Seshadri Sriprasad
Jan 11, 2021·Cancer Research and Treatment : Official Journal of Korean Cancer Association·Hyunsoo RyooHyun Hwan Sung
Apr 24, 2021·Minerva Urology and Nephrology·Alberto AbrateAlchiede Simonato
Jun 15, 2021·Journal of Endourology·Marina PizzighellaBenjamin Pradere

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Methods Mentioned

BETA
biopsy

Software Mentioned

Quality in Prognosis Studies ( QUIPs )
Excel
PRISMA
SPSS
Ligasure

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