Introduction: Upper urinary tract urothelial carcinoma (UTUC) is an uncommon but potentially aggressive entity, whose standard treatment is radical nephroureterectomy with excision of the vesical cuff. The laparoscopic approach has gained prominence due to its benefits associated with minimal invasion.
Clinical case: We present a 75-year-old male patient with a history of hypertension, diabetes, and chronic smoking, who came in with persistent left renal colic and gross hematuria. Imaging studies revealed an obstructive mass in the distal left ureter with severe hydronephrosis. The endoscopic biopsy was compatible with high-grade papillary urothelial neoplasm. Complete clinical staging was performed (T1N0M0) and a two-stage laparoscopic radical nephroureterectomy was carried out, including complete resection of the bladder cuff. The procedure lasted 105 minutes, with minimal blood loss and no complications.
Conclusion: Laparoscopic radical nephroureterectomy with excision of the vesical cuff is a safe, reproducible, and effective option in the management of localized UTUC, as long as the surgical oncological principles are respected.
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Revista Científica
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