Objective  To evaluate the clinical effects of retroperitoneal and transperitoneal laparoscopic radical nephroureterectomy for upper urinary tract urothelial carcinoma.

  Methods  We trospectively analyzed the clinical data of 85 patients with upper urinary tract urothelial carcinoma (UTUC) who underwent laparoscopic radical nephroureterectomy in West China Hospital, Sichuan University, from January 2012 to December 2016. Forty-nine patients (Group A) underwent retroperitoneal laparoscopic radical nephroureterectomy while 36 (Group B) underwent transperitoneal laparoscopic radical nephroureterectomy. Operative time, blood loss volume, time of incision drainage, catheterization time, recovery time of postoperative intestinal function, postoperative hospitalization time, operative complications, postoperative local recurrence, and distant metastasis were compared between the two groups.

  Results  All operations were successfully performed. Mean operative time was (126.9±11.6) min in Group A, while it was (109.9±14.7) min in Group B; thus, mean operative time was significantly shorter in Group B than in Group A (P <0.05). Mean blood loss volume was (108.5±24.1) mL in Group A, while it was (95.1±19.9) mL in Group B; thus, mean blood loss volume was significantly lower in Group B than in Group A (P <0.05). Mean recovery time of postoperative intestinal function was (1.8±0.5) days in Group A, while it was (2.3± 0.4) days in Group B; thus, mean recovery time of postoperative intestinal function was significantly longer in Group B than in Group A (P <0.05). The other evaluated indicators did not differ significantly between the two groups.

  Conclusions  Both retroperitoneal and transperitoneal laparoscopic radical nephroureterectomy are safe and effective as minimally invasive treatment for upper UTUC.