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Nephroureterectomy for Upper Tract Urothelial Carcinoma: Indications and Technique

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Bladder Cancer

Abstract

Radical nephroureterectomy (RNU) remains the gold standard treatment for upper tract urothelial carcinoma (UTUC). In the present chapter, we discuss indications and preparation for surgery, including the use and timing of both systemic and intravesical chemotherapy. We discuss our operative technique in performing RNU, which has largely shifted to a minimally invasive approach at our institution. Based on contemporary evidence concerning the perioperative use of intravesical chemotherapy, we routinely instill intravesical mitomycin C intraoperatively at the time of RNU and excise the bladder cuff to decrease intravesical recurrence. We also typically approach lymph node dissection in a templated fashion, particularly in high-risk patients. Finally, we provide tips to avoid and manage common complications that may arise during or following RNU.

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Authors and Affiliations

  1. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Vitaly Margulis, Rashed A. Ghandour & Nirmish Singla

Authors
  1. Vitaly Margulis
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  2. Rashed A. Ghandour
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  3. Nirmish Singla
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Correspondence to Vitaly Margulis .

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Editors and Affiliations

  1. Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA

    Ashish M. Kamat

  2. Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada

    Peter C. Black

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Margulis, V., Ghandour, R.A., Singla, N. (2021). Nephroureterectomy for Upper Tract Urothelial Carcinoma: Indications and Technique. In: Kamat, A.M., Black, P.C. (eds) Bladder Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-70646-3_38

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  • DOI: https://doi.org/10.1007/978-3-030-70646-3_38

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-70645-6

  • Online ISBN: 978-3-030-70646-3

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