Combined surgery for intra-abdominal extra-urinary lesions in patients with renal and/or ureteral malignancies

Background: The standard treatment for patients with renal and/or ureteral malignancies is radical nephrectomy or nephroureterectomy. Frequently, intra-abdominal extra-urinary lesions are noted preoperatively or intra-operatively in the gastrointestinal or gynecologic tract. We reviewed our experience with patients during an 11-year period. Methods: From 1991 through 2001, 1059 patients underwent radical operations for renal and/or ureteral malignancies. Of these, 37 patients had simultaneous intra-abdominal extra-urinary lesions preoperatively or intra-operatively and underwent surgery for these lesions at the same time as nephrectomy or nephroureterectomy. These patients were designated as group A and were compared with group B patients who underwent only radical urological surgery. Results: The distributions of age, gender, preoperative evaluations, and histology did not differ significantly between the groups. The most common intra-abdominal extra-urinary lesion was located in the gall bladder (51.4%). Although the patients with intra-abdominal extra-urinary lesions tended to have greater intra-operative blood loss (p=0.8621), longer postoperative hospital stays (p=0.3414), and higher complication rates (p=0.208) than those who did not, the differences were not significant. Conclusions: Given radical operations for renal and/or ureteral malignancies, synchronous surgery for intra-abdominal extra-urinary lesions is feasible and safe with thorough postoperative care.