Long-term results and management of ureteral transitional cell carcinoma using the holmium: YAG laser via rigid-ureteroscopy

Yoshiaki Yamada, Yasusuke Inoue, Kogenta Nakamura, Katsuya Naruse, Shigeyuki Aoki, Tomohiro Taki, Motoi Tobiume, Kenji Zennami, Remi Katsuda, Kouji Hara, Yoshiharu Kato, Masahito Watanabe, Keiko Hayashida, Yumi Suzuki, Hitomi Kato, Reiko Ajisaka, Inbou Kyoku, Hiroshi Noguchi, Nobuaki Honda

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5 Citations (Scopus)

Abstract

The standard operative procedure for ureteral transitional cell carcinoma is nephrouterectomy with partial cystectomy at the affected ureteral orifice. However, nephron-sparing surgery and endoscopic surgery and management have become common practice for low-grade and low-stage cases. We investigated the follow-up results of patients who underwent endoscopic surgery using the holmium: YAG laser, and evaluated its treatment effect. The patients were 4 men and 3 women aged from 68 to 87 years (mean: 74.7 years). Two were imperative cases and 5 were elective cases. The tumor size ranged from 8 to 25 mm (mean: 15.4 mm). Hydronephrosis was not found in any case, and urinary cytology was negative in all cases. Biopsy revealed 5 cases of grade 1, and 2 of grade 2. A Versa Pulse Select 80 laser generator, a 365-μm slim line laser fiber, and a rigid ureteroscope with 8F-point diameter were used. A 6F double J catheter was placed postoperatively for 3 weeks. Pulse energy was set at 0.5-1.0 J (mean: 0.8 J) with a frequency of 10 Hz. The total amount of energy was 0.9-11.22 KJ (mean: 2.89 KJ) and the operation time including ureteral stent placement was 20-97 min (mean: 66 min). Neither urinary tract perforation nor ureteral stricture associated with laser irradiation was observed. The postoperative follow-up period ranged from 23-88 months (mean: 67.8 months). Patients underwent urinary cytological examination once a month, and cystoscopy, retrograde pyelography and urethroscopy once every 3 months for 2 years, then once every 6 months thereafter. One patient developed tumor recurrence 23 months after surgery and received another laser treatment, but no recurrence has been observed in the other 6 patients (85.7%). Transurethral endoscopic surgery and management using the holmium: YAG laser is safe and effective nephron-sparing surgery for ureteral transitional cell carcinoma, and good long-term treatment results can be expected even in elective cases if the indications are carefully selected.

Original languageEnglish
Pages (from-to)345-349
Number of pages5
JournalOncology reports
Volume21
Issue number2
DOIs
Publication statusPublished - 2009

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Yamada, Y., Inoue, Y., Nakamura, K., Naruse, K., Aoki, S., Taki, T., Tobiume, M., Zennami, K., Katsuda, R., Hara, K., Kato, Y., Watanabe, M., Hayashida, K., Suzuki, Y., Kato, H., Ajisaka, R., Kyoku, I., Noguchi, H., & Honda, N. (2009). Long-term results and management of ureteral transitional cell carcinoma using the holmium: YAG laser via rigid-ureteroscopy. Oncology reports, 21(2), 345-349. https://doi.org/10.3892/or_00000228