An analysis of the surgical treatment of tumors of the upper urinary tract

: Over a ten-year period (1982-1993), forty-three patients with tumors of the upper urinary tract are operated in the urological clinic of the Medical University--Pleven. The types of operative interventions used include: radical nephroureterectomy with resection of the urinary bladder in 23 patients, with a postoperative incidence of recurrences amounting to 21.7 per cent; nephroureterectomy (7 cases) with 42.85 per cent recurrences; nephroureterectomy plus postoperative endoscopic electrocoagulation of the ureteral residue (9 cases) with 11.85 per cent recurrences; resection of the distal portion of the ureter plus ureterocystoneoanastomosis (4 cases) with 25 per cent recurrences. Analysis of the incidence rate of recurrences after various types of operations shows that nonradical procedures carry greater risk. Patients where for various reasons radical operation is impracticable, postoperative endoscopic electrocoagulation of the ureteral residue and bladder mucosa surrounding its orifice, substantially decrease the incidence rate of recurrences.