Treatment results of conservative surgical approach in upper urinary tract urothelial tumours and our clinical experience

OBJECTIVE: To evaluate treatment results on conservative surgical approach in upper urinary tract urothelial tumours and clinical experience.
STUDY DESIGN: 9 of 17 cases who were evaluated retrospectively were applied conservative surgery (52.9%) or endoscopic approach. 4 of these underwent to partial ureterectomy and end to end anastomosis, 5 cases to endoscopic approach (fulgurusation, electroresection). 8 patients (47%) were performed simple nephroureterectomy or nephroureterectomy with removed out cuff from bladder.
RESULTS: One patient of 9 who applied conservative surgery or endoscopic approach was seen tumour recurrence (11.1%). The median follow-up and survival was 20 months in these patients. 2 of 8 patients who performed nephroureterectomy (25%) died because of the local invasion and other organ métastasés. The median follow-up was 16 months, the median survival was 10 months in these patients.
CONCLUSION: We had better results with conservative surgical approaches than nephroureterectomy procedure in cases low stage-grade upper urinary tract urothelial tumours.

Üst Üriner Trakt Ürotelyal Tümörlerinde Konservativ Cerrahi Yaklaþýmlarla Ýlgili Tedavi Sonuçlarý ve Klinik Deneyimlerimiz

AMAÇ: Üst üriner trakt uretelyal tümörlü olgulara uygulanan konservatif cerrahi yaklaþýmlarin tedavi sonuçlarýný ve klinik deneyimlerimizi deðerlendirmek.
MATERYAL METOD: Retrospektif olarak deðerlendirilen 17 üst üriner trakt üretelyal tümör olgusundan 9‘una (% 52.9) konservatif cerrahi veya endoskopik yaklaþým uygulandý. Bunlardan 4 (%23.5) olguya parsiyel ureterektomi ve end anastomoz, 5 olguya da (% 29.4) endoskopik yaklaþým (fulgurizasyon, elektrorezeksiyon) uygulandý. 8 olguya (%47) da nefroureterektomi simple veya mesaneden cuff çýkarýlmasý ile beraber uygulandý.
BULGULAR: Konservatif cerrahi veya endoskopik yaklaþým uygulanan 9 olgudan (%52.9) sadece 1 olguda (%11.1) tümör rekürrensi görüldü. Bu olgularda ortalama izlem ve ortalama sað kalým süreleri 20 ay idi. Nefroureterektomi uygulanan 8 olgudan (%47) 2‘sinde (%25) ise yaklaþýk 9- 12 ay arasý sürede lokal invazyon ve uzak metastazlar görülerek hastalar kaybedildi. Bu olgularda ortalama izlem süresi 16 ay, ortalama sað kalým süreleri 10 ay idi.
SONUÇ: Üst üriner trakt uretelyal tümörü olan düþük stage, grade‘li olgularda konservatif cerrahi yaklaþýmlarla nefroureterektomiden daha baþarýlý tedavi sonuçlarý elde ettik.