Retroperitoneoscopic nephroureterectomy and ipsilateral bladder cuff resection in peritoneal dialysis-dependent patients: tips for immediate reinstitution

Han Yu Weng, Chien Hui Ou

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To maximize the chance of maintaining peritoneal dialysis (PD) after retroperitoneoscopic nephroureterectomy without interruption in PD-dependent patients who were suspected as having upper tract urothelial carcinoma (UTUC). Methods: During 2005–2018 at our hospital, 10 PD-dependent patients who were suspected as having UTUC underwent hand-assisted retroperitoneoscopic nephroureterectomy (HARN) and bladder cuff resection by a single surgeon. The medical record and post-operative outcomes were retrospectively analyzed. Our surgical tips aiming at staying on PD including keeping adequate but relatively lower insufflation pressure during the operation, reducing the negative pressure of the drain tube post-operatively and initiating PD at a low volume with gradual titration, were also presented in the article. Results: A total of ten patients were enrolled in our study. The first five patients failed to resume PD and need interim hemodialysis due to various reasons. After some technique modifications, all the following five patients have PD reinstitution immediately after the operation without increasing the incidence of post-operative complications. Conclusion: Staying on PD wound be beneficial for those ESRD patients who underwent retroperitoneoscopic nephroureterectomy due to UTUC, mainly to avoid hemodynamic interference and possible complications related to hemodialysis during the peri-operative period. However, it remains challenging for surgeons. We concluded the key points to minimize peritoneal violation. By adherence to our tips, retroperitoneoscopic nephroureterectomy should be strongly considered in PD patients with suspicious UTUC if feasible.

Original languageEnglish
Pages (from-to)2275-2279
Number of pages5
JournalInternational Urology and Nephrology
Volume52
Issue number12
DOIs
Publication statusPublished - 2020 Dec

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology

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