The role of diagnostic ureteroscopy in the era of computed tomography urography.
BMC Urol
; 15: 74, 2015 Jul 25.
Article
em En
| MEDLINE
| ID: mdl-26209444
BACKGROUND: To examine the contemporary role of ureteroscopy in the diagnosis of upper urinary tract urothelial carcinoma. METHODS: We retrospectively evaluated 116 diagnostic ureteroscopies, performed in our institution to rule out primary UTUC. Demographics, cytological findings and interpretation of preoperative imaging were obtained. Ureteroscopic diagnosis and histological results were recorded and the predictive values of diagnostic studies were determined. Follow-up data was reviewed to evaluate the oncological outcomes in patients treated endoscopically. RESULTS: The pre-ureteroscopic evaluation included CTU in 91 (78%) patients. Positive and Negative predictive values of CTU were 76 and 80%, respectively. Typical filling defect on CTU was demonstrated in 38 of 89 patients. UTUC has been ruled out in 9 patients (24%) with suspicious filling defect on CTU. Endoscopic approach was implemented in 7 patients (18%). During a median follow up period of 17 months (IQR, 9-25) none of the followed patients experienced disease progression. CONCLUSIONS: Nephroureterectomy was spared from 42% of patients who underwent diagnostic ureteroscopy for suspected UTUC, demonstrated on CTU. In about half of those patients tumor has been ruled out and the others were managed endoscopically. Therefore, diagnostic ureteroscopy is advised as a crucial step in confirming UTUC and treatment planning.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Urológicas
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Carcinoma de Células de Transição
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Urografia
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Tomografia Computadorizada por Raios X
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Neoplasias Urológicas
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Ureteroscopia
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
BMC Urol
Assunto da revista:
UROLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Israel