Surgery for pulmonary lesions in patients with a history of urinary tract transitional cell carcinoma.

BACKGROUND: There has been little information on the actual diagnosis of pulmonary lesions in patients with a history of urinary tract transitional cell carcinoma (TCC) and short- and long- outcomes of pulmonary resection for these patients. METHODS: In the present study, the data of 37 consecutive patients with a history of TCC who underwent pulmonary resection for solitary pulmonary lesions were reviewed, and the clinical factors and short- and long-term outcomes were analyzed. RESULTS: The study population included 35 male patients, and 2 female patients. The mean age was 72.5 years. Twenty patients (80%) were smokers and showed a high incidence of chronic obstructive pulmonary disease. Pulmonary lesions and primary TCC were detected simultaneously in 5 patients and metachronously in 32 patients. The median interval between treatment for primary TCC and the detection of pulmonary lesion was 43 months. The mean tumor diameter was 23 mm. The types of resection included lobectomy (n = 19), segmentectomy (n = 8), and partial resection (n = 10). Twelve of 37 patients (32%) developed postoperative complications. The pathological diagnoses included primary lung cancer (n = 28), pulmonary metastasis from TCC (n = 7), and others (n = 2). The 5-year overall survival rate for all patients was 72%. The 5-year overall survival rate of patients with primary lung cancer was 74%, while that of patients with pulmonary metastasis from TCC was 57%. CONCLUSIONS: Surgery can be proactively considered for treating pulmonary lesions in patients with a previous history of TCC, as it provides favorable long-term outcomes.

Application of different operative approaches for laparoscopic treatment of upper urinary tract transitional cell carcinoma / 中华泌尿外科杂志

Objective To analyze the different approaches and their indications in the laparo-scopic treatment of upper urinary tract transitional cell carcinoma. Methods 94 patients with upper urinary tract transitional cell carcinoma were divided to two groups. Group A (63 cases) with renal pelvic and ugper ureteral carcinoma were treated with retroperitoneal approach laparoscopic surgery and transurethral reseetoscope surgery. Group B (31 cases) with middle ureteral carcinoma including 6 cases with ureteral local infiltration were treated through 70° recumbent position transperitoneal ap-proach laparoscopic surgery combined with bladder cuff resection. The operative time, blood loss, the intestinal functional recovery time and post-operative complications were recorded. Results All 94 procedures were successfully completed, with no complication during the surgery. The mean operation time of A and B group was 156.5 and 160.8 min;the mean blood loss was 80 and 86 ml; the mean hos-pital stay was 8 and 8. 5 d; the time of bowel functional recovery of group A and group B was 24-48 and 24-72 h, respectively. 84 cases were followed-up with mean follow-up time of 23 months. Three eases and 5 cases were found having bladder tumor in the group A and group B. The incision and port metastasis was not found. Conclusions It is safe and feasible to treat the upper urinary tract transi-tional cell carcinoma laparoscopically. The selection of operating approach is mainly based on the loca-tion and local infiltration status of the tumor.