Abstract
Introduction:
Suspicious bilateral upper tract urinary cancer (bUTUC) is a challenging scenario both for diagnosis and treatment reasons. 1 –3 We evaluated the feasibility and safety of synchronous bilateral endoscopic treatment for UTUC.
Materials and Methods:
A synchronous bilateral approach was performed in case of suspicious organ-confined bUTUC identified at preoperative contrast-enhanced CT scan. A retrograde or antegrade approach was selected according to tumor location and patient characteristics. Suspicious lesions were biopsied and subsequently ablated using Ho:YAG, Th:YAG, or thulium fiber laser. Herein, we report intra- and postoperative data from 10 consecutive patients treated between 2016 and 2022 and a video describing a case of combined retrograde/antegrade approach for bUTUC treatment.
Results:
Overall, 18 and 2 retrograde and antegrade approaches were performed, respectively. In 14 (70%) cases, a suspicious lesion was identified. Of these, 9 (64%) and 5 (36%) were low- and high-grade tumors. The median operative time was 95 minutes (interquartile range [IQR]: 77.5–120). Intraoperative complications were detected in two (10%) cases. Particularly, one case of minor bleeding and one case of urine leakage occurred, both not requiring further treatment. After a median follow-up of 30 (IQR: 15–46) months, one monolateral and one bilateral recurrence were recorded. Conversely, two patients were treated with radical nephroureterectomy. In the presented case, a 74-year-old woman with Lynch syndrome and bUTUC diagnosis was treated using antegrade and retrograde approaches. No recurrence was detected at Ureterorenoscopy II-look and 9-month follow-up CT scan.
Conclusions:
Bilateral synchronous endoscopic treatment is safe and effective. Patient selection and surgeon's experience are pivotal.
Patient Consent Statement:
Authors have received and archived patient consent for video recording/publication in advance of video recording of procedure.
Authors disclose any commercial associations during the past 3 years that might create a conflict of interest in connection with the video
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Runtime of video: 5 mins 00 secs
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