What is the role of conservative open surgery in renal transitional cell carcinoma treatment?

Updated: Nov 05, 2019
  • Author: Bagi RP Jana, MD, MBA, MHA, FACP; Chief Editor: E Jason Abel, MD  more...
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Answer

Conservative excision for upper urinary tract urothelial tumors includes segmental ureteral resection with reanastomosis or ureteroneocystostomy and partial nephrectomy. Conservative management is especially appropriate for solitary or functionally dominant kidneys, bilateral tumors, or small, low-grade ureteral tumors.

Upper ureteral and midureteral tumors may be treated with segmental resections if they are low-grade, solitary lesions.

Distal ureteral tumors may be treated with distal ureterectomy and ureteral reimplantation if no evidence of multifocality is noted. In these cases, distal ureterectomy may be as successful as total nephroureterectomy because proximal spread of UC after resection is rare.

Partial nephrectomy may be performed in patients with localized renal pelvic tumors; however, this approach should be employed only in situations requiring avoidance of renal failure.


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