A new technique for ureteral resection to prevent urine dissemination and cancer seeding

Hayato Hoshina; Toru Sugihara; Masayuki Kurokawa; Kaori Endo; Ei-Ichiro Takaoka; Satoshi Ando; Haruki Kume; Tetsuya Fujimura

doi:10.1002/iju5.12777

A new technique for ureteral resection to prevent urine dissemination and cancer seeding

IJU Case Rep. 2024 Aug 26;7(6):454-458. doi: 10.1002/iju5.12777. eCollection 2024 Nov.

Authors

Hayato Hoshina¹, Toru Sugihara¹, Masayuki Kurokawa¹, Kaori Endo¹, Ei-Ichiro Takaoka¹, Satoshi Ando¹, Haruki Kume², Tetsuya Fujimura¹

Affiliations

¹ Department of Urology Jichi Medical University Hospital Shimotsuke Japan.
² Department of Urology, Graduate School of Medicine The University of Tokyo Bunkyo-ku Japan.

Abstract

Introduction: We describe a case in which robot-assisted radical ureterectomy was performed for residual ureteral recurrence in a postoperative patient with renal pelvis cancer.

Case presentation: A 75-year-old woman underwent laparoscopic radical nephroureterectomy for left renal pelvic cancer at another hospital. During follow-up, a papillary tumor was found in the bladder on cystoscopy, and a continuous tumor was found in the residual ureter on computed tomography. Robot-assisted radical ureterectomy was performed in combination with transurethral resection of bladder tumors. To avoid urine spillage, bladder cuff excision was performed using a mechanical suture device while monitoring the interior of the bladder.

Conclusion: We developed a new technique for remnant ureteral resection using cystoscopy and a vascular stapler to prevent urine dissemination and cancer seeding.

Keywords: laparoscopic radical nephroureterectomy (LNU); recurrence; robot‐assisted radical ureterectomy (RAU); transurethral resection of the bladder tumor (TURBT); upper tract urothelial cancer (UTUC).