Upper Tract Urothelial Cancer
Upper tract urothelial cancer (UTUC) is a rare malignancy affecting the lining of the kidney (renal pelvis) and ureter (the tube connecting the kidney to the bladder).
It shares similarities with bladder cancer, as both originate from urothelial cells, but UTUC tends to be more aggressive, with a higher risk of invasion into surrounding tissues. Risk factors include smoking, occupational chemical exposure, chronic urinary infections, and genetic conditions like Lynch syndrome. Symptoms often include blood in the urine (haematuria), flank pain, or obstruction of urine flow. Diagnosis involves a combination of urine cytology, imaging (CT urography), and ureteroscopy with biopsy.
Key Risk Factors:
Occupational chemical exposure
Chronic urinary infections
Genetic conditions eg Lynch syndrome
Symptoms to Watch For:
Blood in urine
Obstruction of urine flow
Laparoscopic and Robotic Nephroureterectomy
For high-risk or invasive UTUC, the gold-standard treatment is radical nephroureterectomy, which involves removal of the kidney, ureter, and a small portion of the bladder where the ureter inserts. This can be performed laparoscopically or robotically, offering minimally invasive benefits compared to open surgery. Laparoscopic nephroureterectomy involves small incisions and specialized instruments, leading to less blood loss, reduced pain, and faster recovery. Robotic-assisted nephroureterectomy, using the Da Vinci surgical system, enhances precision, control, and visualization, particularly for the challenging bladder cuff removal. Both approaches offer excellent cancer control while minimizing surgical trauma, allowing for a quicker return to normal activities.
Benefits
Minimally invasive, leading to smaller incisions, less blood loss, and reduced pain.
Faster recovery and shorter hospital stay.
Effective cancer control with minimal surgical trauma.
For high-risk or invasive UTUC, the gold-standard treatment is radical nephroureterectomy, which involves removal of the kidney, ureter, and a small portion of the bladder where the ureter inserts. This can be performed laparoscopically or robotically, offering minimally invasive benefits compared to open surgery. Laparoscopic nephroureterectomy involves small incisions and specialized instruments, leading to less blood loss, reduced pain, and faster recovery. Robotic-assisted nephroureterectomy, using the Da Vinci surgical system, enhances precision, control, and visualization, particularly for the challenging bladder cuff removal. Both approaches offer excellent cancer control while minimizing surgical trauma, allowing for a quicker return to normal activities.
Benefits
Minimally invasive, leading to smaller incisions, less blood loss, and reduced pain.
Faster recovery and shorter hospital stay.
Effective cancer control with minimal surgical trauma.