AccScience Publishing / Bladder / Online First / DOI: 10.14440/bladder.2025.0007
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RESEARCH ARTICLE

Efficacy and safety of modified laparoscopic single-position radical nephroureterectomy with bladder cuff resection for upper urinary tract urothelial carcinoma: A single-center retrospective study

Fei Wu1† ,  Zhen Wang1,2† ,  Liang Sun1 ,  Meixia Zhang1 ,  Hao Ning1 ,  Zhihong Niu1 ,  Jiaju Lyu1,3 ,  Dexuan Gao1*
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1 Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250014, China
2 Department of Urology, Jinan Third People’s Hospital, Jinan, Shandong 250101, China
3 Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250199, China
Bladder, e21200049 https://doi.org/10.14440/bladder.2025.0007
Submitted: 2 January 2025 | Revised: 9 March 2025 | Accepted: 21 April 2025 | Published: 3 July 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: Radical nephroureterectomy (RNU) with bladder cuff excision represents the standard treatment for high-risk upper tract urothelial carcinoma (UTUC). Objective: This study aimed to evaluate the safety, feasibility, and clinical outcomes of a modified laparoscopic single-position RNU plus bladder cuff resection. Methods: This retrospective analysis examined patients diagnosed with UTUC who underwent RNU between May 2022 and July 2024. Participants were divided into three groups: Group A (39 patients) underwent the modified technique, Group B (38 patients) received standard laparoscopic nephroureterectomy with bladder cuff resection, and Group C (27 patients) had laparoscopic nephroureterectomy with an additional lower abdominal incision for bladder cuff resection. We compared baseline characteristics, intraoperative variables, and post-operative outcomes among the groups. Results: A total of 104 patients were included and analyzed. Their baseline characteristics showed no significant differences among groups (p>0.05). Group A experienced a significantly shorter operative time and earlier ureteral catheter removal compared to Groups B and C (p<0.05). Intraoperative blood loss, gastrointestinal recovery time, and length of hospital stay were comparable between Groups A and B, but the results in the two groups were more favorable against Group C (p<0.05). Follow-up revealed no significant differences in tumor recurrence and metastasis rates across groups (p>0.05). Conclusion: The modified laparoscopic single-position RNU in combination with bladder cuff resection is a safe and effective minimally invasive approach for UTUC, offering advantages like reduced operative time, early catheter removal, and enhanced patient recovery, supporting its broader clinical application.

Keywords
Upper urinary tract urothelial carcinoma
Radical nephroureterectomy
Modified technique
Bladder cuff resection
Funding
This project was supported by the National Natural Science Foundation of China (No. 82473422). Dr. Fei Wu was supported by the Taishan Scholar Youth Expert Program of Shandong Province (tsqn202312349) and the Key Talent Program of Shandong First Medical University (Grant No.: ggrc20231101).
Conflict of interest
The authors declare no conflicts of interest.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific
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