Abstract

UPPER EXCRETORY TRACT TUMOR TVEUS: RETROSPECTIVE STUDY OVER A PERIOD OF 5 YEARS; EPIDEMIOLOGICAL, CARCINOGENESIS, DIAGNOSTIC, THERAPEUTIC AND SURGICAL TECHNIQUES ASPECTS OF NUT, PRINCIPLES OF ONCOLOGICAL MONITORING RULES AND LITERATURE REVIEW. EXPERIENCE

*Dr. Conde Fadama, Dr. Belhaj Karim, Dr. Larbi Hamedoune, Dr. Lamghari Aziz, Dr. Boukhlifi Youness, Pr. Nabil Louardi, Pr. Elbahri, Pr. Alami Mohammed and Pr. Ahmed Ameur

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Abstract

Introduction: Tumors of the upper excretory tract (TVEUS) are urological tumors occupying 5% of UC whose main symptom remains macroscopic hematuria in 80% of cases. This. The objective of this study is to evaluate the different aspects. Material Method: This is a retrospective study spread over 05 years concerning 32 patients diagnosed and treated between 2017 and 2022. The qualitative and quantitative characteristics were analyzed then compared to certain previous series. Results: At the end of this investigation, 32 patients were diagnosed and treated, the average age was 68.5 years, the sex ratio was 10.66 M/1F. The pyelo-calyceal locations are the most represented…68.75%. The clinical symptoms were marked by macroscopic hematuria in 100% cases. Chronic smoking weaned or active equal to 84.37%. Uroscanner was the most represented radiological technique, i.e. 96,875%. The radical therapeutic attitude by NUT was the reference treatment adopted in this series 96.875% more or less associated with the realization of a collar resection equal to 59%. Open approach at 59%, laparoscopic approach equal to 38%, ureteroscopy at 3%. The high grade on the surgical specimen was 84.37%. The other less therapeutic ones (radiotherapy, chemotherapy, and local immunotherapy) are complementary or possibly palliative to surgical excision. Clinical and paraclinical monitoring allowed us to detect five cases of bladder recurrence. The prognosis is essentially linked to tumor stages and grades as well as the surgical procedure. Conclusion: Tumors of the upper excretory tract are rare and invasive, the diagnosis of which is based on a combination of clinical, radiological or endourological arguments. NUT remained the reference treatment. The real challenge remains cancer control and preservation of renal function.Strict follow-up in specialized consultation is necessary to finally diagnose recurrence and progression.

Keywords: Tumor of the upper excretory tract (TVEUS), total nephroureterectomy (NUT), bladder cuff, laparoscopy, laparotomy, exploratory or diagnostic ureteroscopy.