Refined pluck technique 彰基經驗
蔡秉浩、陳俊吉、江恒杰、嚴孟意、黃勝賢、張進寶、張建祥、王百孚
彰化基督教醫院 外科部 泌尿科；
Refined pluck technique: single institution experience
Ping Hao, Tsai Chun-Chi, Chen Heng-Chieh, Chiang Meng-Yi, Yan Sheng-Hsien, Huang Chin-Pao, Chang Jian-Xiang, Zang Pai-Fu, Wang
Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan;
Purpose: To evaluated the feasibility of refined pluck technique by ureteral occlusion and transurethral cystorrhaphy in nephroureterectomy with bladder cuff excision for upper tract urothelial carcinoma (UTUC).
Materials and Methods: Between 2014, Jan to 2017, Dec. 81 patients were operated for UTUC in our hospital under the service of seven attending. Their records were analyzed retrospectively. 20 out of 81 patients received refined pluck technique , and all these procedure were done by one attending with robotic assistance. The rest 61 patients received nephroureterectomy with bladder cuff excision without ureteral occlusion and transurethral cystorrhaphy were done by other attending with open method or hand-assisted or pure laparoscopic method.
Results: Among 81 patients, 11 patients had urothelial carcinoma developed in urinary bladder during follow up. 10 out of 11 patients were previouslu accepted nephroureterectomy with bladder cuff excision without ureteral occlusion and transurethral cystorrhaphy had urothelial carcinoma developed in urinary bladder during follow up. One patient who previously received refined pluck technique had urothelial carcinoma developed in urinary bladder during follow up.
Conclusions: This refined pluck technique by ureteral occlusion and transurethral cystorrhaphy in nephroureterectomy with bladder cuff excision for upper tract urothelial carcinoma (UTUC) is a safe and effective alternative according to our preliminary experience. Long term follow-up and larger patient number are needed