Critical Considerations regarding Laparoscopic Nephroureterectomy for the Treatment of Upper Urinary Tract Carcinoma

ObjectivesTo review the pro and con arguments for a laparoscopic approach for the treatment of upper urinary tract cancer.MethodsFourteen series comparing open nephroureterectomy (NUT) with laparoscopic NUT have been studied with regards to cancer control and related morbidity.ResultsEvent though the open approach is still the gold standard treatment, the laparoscopic approach has shown its applicability with a favourable safety profile while providing good oncologic outcome. In comparative as well as noncomparative series, results were comparable for the development of local recurrences (4% vs. 6%) and distant metastases (15.5% vs. 15.1%), and patient's long-term survival (2-yr survival: 75% vs. 76%) following laparoscopic and open NUT, respectively.However, certain types of laparoscopic bladder cuff control led to insufficient prevention of bladder recurrences.ConclusionsLaparoscopic NUT provides an oncologic outcome comparable to open surgery when performed in patients with early-stage diseases.