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POINT OF TECHNIQUE

positioned within 10 min. Difficult positioning manoeuvres that are necessary in obese patients still require patience and repeated adjustments. The technique described will facilitate rapid localisat ion. Requests for reprints to: J. Talati, Department of Surgery (Urology), The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi-74800, Pakistan.

Safer Nephroureterectomy in the Treatment of Transitional Cell Carcinoma of the Upper Urinary Tract

Techniique Three men underwent nephroureterectomy over a 12-month period. Two had cancer in the renal pelvis and 1 in the lower ureter. All had positive cytology. Urine was collected for cytological examination and the ureteric orifice on the side of the lesion was coagullated transurethrally. The bladder was washed out with distilled water and then filled with the same fluid until it could be opened following nephrectomy. The bladder was then emptied, washed out once more, and this sample was sent for cytological examination. The ureter was removed with the surrounding bladder wall. One year post-operatively the patients remain free of recurrences.

References P. PERlMENlS and G . BARBALIAS, Departmentof Urology, University of Patras, Patras, Greece

Tumours of the renal pelvis and ureter account for approximately 2% of genitourinary malignancies (Johnson et al., 1988). Newman et al. (1967) suggested that nephroureterectomy, with a cuff of bladder, is the most effective treatment. Special care must be taken to minimise recurrences due to the spread of cancer cells within the wound (Novick and Stewart, 1976).

Johnson, E. D., Swanson, A. D. and von Eschenbach, C. A. (1988). Tumors of the genitourinary tract. In Smith'sGeneral Urology, ed. Tanagho, E. A. and McAnich, J . W. Chapter 19, pp. 330421. Connecticut: Appleton and Lange. Newmaim, D. M., Lawrence, E. A., Wishard, W. N. et d.(1967). Transitional cell carcinoma of the upper urinary tract. J. Urol., 98, 322-327. Novick, A. C. and Stewart, B. H. (1976). Partial cystectomy in the treatment of primary and secondary carcinoma of the bladder. J. Urol., 116,570-574. Requesls for reprints to: P. Perimenis, 42 Nafpactou Street, GR 26331 Patras, Greece.

Safer nephroureterectomy in the treatment of transitional cell carcinoma of the upper urinary tract.

667 POINT OF TECHNIQUE positioned within 10 min. Difficult positioning manoeuvres that are necessary in obese patients still require patience and re...
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