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KẾT QUẢ PHẪU THUẬT CẮT THẬN-NIỆU QUẢN TẬN GỐC ĐIỀU TRỊ UNG THƯ NIỆU MẠC ĐƯỜNG TIẾT NIỆU TRÊN TẠI BỆNH VIỆN CHỢ RẪY
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Abstract
Objectives: evaluation of surgical outcomes of radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC). Materials and Methods: Retrospective descriptive case series study. Data from patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy (RNU) at Cho Ray Hospital, from January 2017 to December 2023. Results: a total of 148 cases of upper tract urothelial carcinoma (UTUC) were diagnosed and treated with radical nephroureterectomy at Chợ Rẫy Hospital. The male proportion was 62.8%, with a mean age of 63,7 ± 10,2 years (range: 33-85). Surgical approaches included 67 open surgeries and 81 laparoscopic surgeries, with 8 cases (9.9%) requiring conversion from laparoscopy to open surgery. Operative time: Open surgery: 243,2 ± 63.79 minutes, Laparoscopic surgery: 261,7 ± 60.05 minutes (p=0.06). Lymph node dissection rate: Open surgery: 68.7%, Laparoscopic surgery: 44.1% (p=0.003). Estimated blood loss: Open surgery: 332.1 ± 276.87 mL, Laparoscopic surgery: 238,3 ± 227.25 mL (p=0.029). Hospital stay: Open surgery: 7.7 ± 1.9 days, Laparoscopic surgery: 7.1 ± 1.7 days (p=0.039). The intraoperative complication rate is 7.5%, including pleural injury (3.4%), vascular injury (3.4%), and intra-abdominal organ injury (0.7%). The postoperative complication rate is 20.9%, with minor complications (Clavien-Dindo grade I-II) accounting for 17.6%, major complications (grade III-V) for 3.3%, and a perioperative mortality rate of 1.3%. Conclusion: Radical nephroureterectomy is the gold standard in the treatment of upper tract urothelial carcinoma. Laparoscopic surgery has lower blood loss, shorter hospital stays, and lower lymph node dissection rates than open surgery. The postoperative complication rate is 20.9%.
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Keywords
upper tract urothelial carcinoma, radical nephroureterectomy
References
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