Study on the abscission of UTUC tumor cells by dissociating kidney and ureter with laparoscopic

• 1、The second hospital of Tianjin Medical University

Abstract：Objective:The incidence of intravesical recurrence (IVR) is very high in patients with upper tract urothelial carcinoma (UTUC) after laparoscopic nephroureterectomy (LNU) combined with lower abdominal oblique incision bladder cuff resection. The purpose of this study was to analyze the changes of urinary tumor cells in the bladder before and during the operation by LNU combined with oblique incision bladder cuff resection in patients with UTUC, and to explore whether LNU surgical procedures increase the probability of tumor cells shed into the bladder. Methods:A total of 59 patients who were diagnosed as UTUC at the Second Hospital of Tianjin Medical University from January 2019 to January 2020 were collected in this experiment. Each research subject underwent LNU combined with oblique incision of the lower abdomen for bladder cuff-like resection. The patients were given the same amount of urine in the bladder before and during bladder cuff-like resection. An experimental method of fluorescent staining of acridine orange in exfoliated cells to find tumor cells in urine.59 cases of preoperative urine and intraoperative urine tumor cell changes were analyzed to explore the effect of LNU surgery on the UTUC tumor cell shedding into the bladder. In the statistical analysis, χ2 test was performed on the data of DNA ploidy analysis research results of urine exfoliated cells, and paired t test and correlation analysis were performed on the results of fluorescent staining of acridine orange in urine exfoliated cells. Results:32 urine samples of 59 UTUC patients underwent DNA ploidy analysis of urinary exfoliated cells. The results showed that 17 and 20 patients with tumor-positive urine samples were collected before and during operation, P = 0.611, no obvious statistics Learn the differences. In addition, the results of fluorescent staining of acridine orange in urine samples from 27 patients showed that the mean tumor cell contents in urine before and during operation were 1.56 ± 1.739 and 2.37 ± 2.762, p = 0.147, ρ = 0.276, There was no obvious statistical difference. The results of the study showed that there was no significant change in the amount of shed tumor cells in urine specimens before and during operation.Conclusions:There was no significant difference in the amount of tumor cells in the urine of patients with UTUC before and during the operation. Therefore, we believe that LNU did not increase the risk of tumor cells falling out into the bladder during the operation.

Keywords： Upper tract urothelial carcinoma Intravesical recurrence Laparoscopic nephroureterectomy