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Complications of Nephroureterectomy

  • Abhishek Srivastava
  • Reza Ghavamian
Chapter

Abstract

Open radical nephroureterectomy (ONU) and excision of the ipsilateral ureteral orifice with a periureteral cuff of the bladder is the gold standard for the treatment of upper tract urothelial cancer (UTUC). Laparoscopic techniques were introduced as a less invasive alternative in 1991 by Clayman et al. The use of minimally invasive nephroureterectomy (MINU) has increased for the management of UTUC with majority of nephroureterectomies being performed robotically. Patients with UTUC are often elderly and comorbid secondary to associated risk factors for developing this malignancy. Significant perioperative complications may occur in this surgical population with rates as high as 40%. Preoperative considerations include medical optimization, patient positioning, antibiotic prophylaxis, and deep venous thrombosis prophylaxis. Intraoperative vascular, bowel, and adjacent organ injuries are potential serious complications that can be life-threatening. The incidence and effects of many complications can be minimized with meticulous attention to the anatomical details and proper surgical techniques.

Keywords

Nephroureterectomy Complications Upper tract Transitional cell cancer Laparoscopy Robotic Nephrectomy Ureter Bladder cuff Oncology 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology, Montefiore Medical CenterAlbert Einstein College of MedicineBronxUSA
  2. 2.Department of Urology, Northwell HealthNorthwell Hofstra School of MedicineHempstedUSA

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