75–45 degree conversion-modified posterior laparoscopic one-piece radical surgery for uroepithelial carcinoma

OBJECTIVE To determine whether a modified procedure of one-piece total retroperitoneal laparoscopic total nephroureterectomy with bladder sleeve resection is safe and efficacious in treating upper urinary tract uroepithelial carcinoma (UTUC). METHODS This study involved 24 UTUC patients (16 men and 8 women) who underwent this procedure at our hospital between January 2022 and June 2022. The average age was 73 (range 62 − 91). Of the 24 cases, 15 were on the left side, and 9 were on the right. There were 8 and 6 cases of lower and upper ureteral tumor, respectively, and 10 cases of renal pelvis tumor. RESULTS There was no instance of intermediate opening, and all the operations were completed successfully. The surgical procedure took 60–100 min (mean 71.25 ± 9.80) min. No significant intraoperative or postoperative problems occurred. Postoperative chemotherapy for the bladder was administered as usual. CONCLUSION For UTUC, the modified one-piece total retroperitoneal laparoscopic total nephroureterectomy combined with bladder sleeve resection is a successful and manageable procedure that offers satisfactory tumor control and merits further development in clinical practice.