Surgery for upper tract transitional cell carcinoma

Upper tract transitional cell carcinoma is an uncommon cancer mainly affecting the draining system of the kidney (kidney pelvis) and ureter (the tube through which urine passes from the kidney to the bladder). The main treatment approach for this condition is surgical removal of the malignant area. There are a number of surgical techniques for this procedure and the aim of this review was to compare them and determine which was the most effective in terms of surgical ease, patient morbidity, clinical outcome and cost. Our search of the literature found no high quality evidence comparing different surgical techniques. Evidence from one small randomised trial and observational studies suggests that laparoscopic surgical intervention may reduce blood loss, post-operative pain and hospital stay. However, the quality of the evidence is poor and, therefore, it is not possible to recommend the most effective surgical procedure to replace the existing clinical practice for managing upper tract transitional cell carcinoma.