Ureteroscopic laser treatment of upper tract transitional cell carcinoma
Objective: The improvement of flexible ureteroscopy, thanks to devices’ miniaturization and new armamentarium, has contribute to the development of endoscopic treatment for upper tract urothelial carcinoma (UTUC). UTUC laser treatment can also be offered to a subgroup of patients currently considere...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Urology Video Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590089722000470 |
| _version_ | 1811309689473859584 |
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| author | A. Sierra M. Corrales O. Traxer |
| author_facet | A. Sierra M. Corrales O. Traxer |
| author_sort | A. Sierra |
| collection | DOAJ |
| description | Objective: The improvement of flexible ureteroscopy, thanks to devices’ miniaturization and new armamentarium, has contribute to the development of endoscopic treatment for upper tract urothelial carcinoma (UTUC). UTUC laser treatment can also be offered to a subgroup of patients currently considered high risk. This video offers tips on how to perform kidney-sparing treatment (KST) at this group. Patients and surgical procedure: 79-year-old man with history of UTUC. Prior left nephroureterectomy for a 3cm inferior ureteral tumor in 2007 (AP T1AG). Annual recurrence of non-invasive bladder carcinoma during the follow-up. In 2019 a 1 cm low-grade UTUC was diagnosed, treated endoscopically. Referred to our hospital for a 3 cm recurrence in less than one year without metastasis and negative cytology. Results: The patient underwent conservative treatment for UTUC. The flex-XC1 (Karl Storz, Tuttlingen, Germany) and Thulium fiber laser (TFL) (Fiber Dust, Quanta System Samarate, Lombardia, Italy) with a 200µm fiber were used. Energy pulse and frequency pulse were 1J and 10 Hz, respectively. Total energy used was 12 KJ. There were no intraoperative complications with complete tumor resection, after 45 min. 24 hours hospital stay. A second look was planned 4 weeks later. After 3- and 6-months follow-up a diagnostic flexible ureteroscopy (fURS) was performed without any lesion. Conclusion: In low-grade patients with non-invasive UTUC, KST with TFL appears to be the best option without compromising the oncological results nor the kidney function. In select patients with an imperative indication, KST can be considered, however a stringent follow-up after the intervention is the key element to success. |
| first_indexed | 2024-04-13T09:45:58Z |
| format | Article |
| id | doaj.art-b388c2aced984ee88a4a9be2449102ed |
| institution | Directory Open Access Journal |
| issn | 2590-0897 |
| language | English |
| last_indexed | 2024-04-13T09:45:58Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Urology Video Journal |
| spelling | doaj.art-b388c2aced984ee88a4a9be2449102ed2022-12-22T02:51:46ZengElsevierUrology Video Journal2590-08972022-09-0115100170Ureteroscopic laser treatment of upper tract transitional cell carcinomaA. Sierra0M. Corrales1O. Traxer2Sorbonne University GRC Urolithiasis no. 20 Tenon Hospital, F-75020 Paris, France. Sorbonne University, Department of Urology AP-HP, Tenon Hospital, F-75020 Paris, FranceSorbonne University GRC Urolithiasis no. 20 Tenon Hospital, F-75020 Paris, France. Sorbonne University, Department of Urology AP-HP, Tenon Hospital, F-75020 Paris, FranceCorresponding author at: Sorbonne University GRC Urolithiasis no. 20 Tenon Hospital, F-75020 Paris, France. Sorbonne University, Department of Urology AP-HP, Tenon Hospital, F-75020 Paris, France; Sorbonne University GRC Urolithiasis no. 20 Tenon Hospital, F-75020 Paris, France. Sorbonne University, Department of Urology AP-HP, Tenon Hospital, F-75020 Paris, FranceObjective: The improvement of flexible ureteroscopy, thanks to devices’ miniaturization and new armamentarium, has contribute to the development of endoscopic treatment for upper tract urothelial carcinoma (UTUC). UTUC laser treatment can also be offered to a subgroup of patients currently considered high risk. This video offers tips on how to perform kidney-sparing treatment (KST) at this group. Patients and surgical procedure: 79-year-old man with history of UTUC. Prior left nephroureterectomy for a 3cm inferior ureteral tumor in 2007 (AP T1AG). Annual recurrence of non-invasive bladder carcinoma during the follow-up. In 2019 a 1 cm low-grade UTUC was diagnosed, treated endoscopically. Referred to our hospital for a 3 cm recurrence in less than one year without metastasis and negative cytology. Results: The patient underwent conservative treatment for UTUC. The flex-XC1 (Karl Storz, Tuttlingen, Germany) and Thulium fiber laser (TFL) (Fiber Dust, Quanta System Samarate, Lombardia, Italy) with a 200µm fiber were used. Energy pulse and frequency pulse were 1J and 10 Hz, respectively. Total energy used was 12 KJ. There were no intraoperative complications with complete tumor resection, after 45 min. 24 hours hospital stay. A second look was planned 4 weeks later. After 3- and 6-months follow-up a diagnostic flexible ureteroscopy (fURS) was performed without any lesion. Conclusion: In low-grade patients with non-invasive UTUC, KST with TFL appears to be the best option without compromising the oncological results nor the kidney function. In select patients with an imperative indication, KST can be considered, however a stringent follow-up after the intervention is the key element to success.http://www.sciencedirect.com/science/article/pii/S2590089722000470UTUCKSTfURSTFLTCC |
| spellingShingle | A. Sierra M. Corrales O. Traxer Ureteroscopic laser treatment of upper tract transitional cell carcinoma Urology Video Journal UTUC KST fURS TFL TCC |
| title | Ureteroscopic laser treatment of upper tract transitional cell carcinoma |
| title_full | Ureteroscopic laser treatment of upper tract transitional cell carcinoma |
| title_fullStr | Ureteroscopic laser treatment of upper tract transitional cell carcinoma |
| title_full_unstemmed | Ureteroscopic laser treatment of upper tract transitional cell carcinoma |
| title_short | Ureteroscopic laser treatment of upper tract transitional cell carcinoma |
| title_sort | ureteroscopic laser treatment of upper tract transitional cell carcinoma |
| topic | UTUC KST fURS TFL TCC |
| url | http://www.sciencedirect.com/science/article/pii/S2590089722000470 |
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