Laparoscopic Nephroureterectomy: The Distal Ureteral Dilemma

Table 1

Summary of perioperative results and oncological outcomes for the different distal ureteral management techniques from selected larger studies. (ND: no data; LOS: length of stay; f/u: mean followup).

	f/u	𝑛	Procedure type	Number of complications of distal ureter technique	Median LOS (days)	Positive margins	Bladder recurrence (%)	Pelvic recurrence (no)	No. of cancer-specific deaths
Pluck technique
Palou et al., 1995 [13]	20	31	ONU	1	ND	ND	35	0	2
Ubrig et al., 2004 [15]	44	18	ONU	1	11	ND	50	0	5
Geavlete et al., 2007 [16]	44	72	ONU	2	10	ND	24	0	9
Laguna and de la Rosette, 2001 (meta-analysis) [18]	n/a	129	ONU/LNU	3	ND	ND	24	4	ND
Ko et al., 2007 [23]	22	19	ONU/LNU	0	7.3	0	26	1	1
Modification of Pluck technique
Agarwal et al., 2008 [26]	15	13	LNU	0	7.3	0	38	0	1
Ureteral deroofing
Shalhav et al., 2000 [29]	24	24	LNU	2	6.1	ND	23	3	ND
Pluck in HALNU
Wong and Leveillee, 2002 [32]	8	14	HALNU	ND	2	ND	14	ND	ND
Laparoscopic extravesical ureteral stapling
Jarrett et al., 2001 [39]	24	25	LNU	0	4	1	48	0	2
Laparoscopic transvesical ureteral ligation
Gill et al., 2000 [41]	11	42	LNU	1	2.3	3	24	0	2
Open distal ureteral excision
Klingler et al., 2003 [49]	22	19	LNU	0	8.1	0	ND	0	ND
Tsujihata et al., 2006 [53]	ND	49	ONU/LNU	0	4	ND	31	0	2
Taweemonkongsap et al., 2008 [54]	27	60	ONU/LNU	0	9	ND	37	3	8