Intravesical incision of the bladder cuff (IVBC) may provide better oncologic outcomes than non-intravesical techniques among patients undergoing radical nephroureterectomy for upper urinary tract urothelial carcinoma (UTUC).

In a systematic review and meta-analysis of 9 international studies involving 4683 patients with primary UTUC, investigators found no significant differences among IVBC, extravesical incision of the bladder cuff (EVBC), and transurethral incision of the bladder cuff (TUBC) techniques.

Compared with IVBC, however, non-IVBC methods were significantly associated with 37% and 45% increased risks of overall recurrence and intravesical recurrence, respectively, Shicong Lai, MD, and colleagues from the Chinese Academy of Medical Sciences in Beijing reported in the International Journal of Surgery. No significant differences were found between the EVBC and TUBC groups.

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“The findings suggest that IVBC is associated with improved oncologic outcomes and that it may be recommended for distal ureter management,” Dr Lai’s team wrote. Due to the small sample size and study limitations, the investigators encouraged future randomized controlled trials.

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Lai S, Guo R, Seery S, et al. Assessing the impact of different distal ureter management techniques during radical nephroureterectomy for primary upper urinary tract urothelial carcinoma on oncological outcomes: a systematic review and meta-analysis. Intl J Surg. doi: 10.1016/j.ijsu.2020.01.016