Objective To evaluate the application and effectiveness of comprehensive lymph node dissection(LND)in laparoscopic radical nephroureterectomy for renal pelvis cancer.Methods A retrospective analysis was conducted on 26 cases of laparoscopic radical nephroureterectomy with LND performed at the Department of Urology,Shenzhen Hospital,Chinese Academy of Medi-cal Sciences,from January 2021 to August 2023.All surgeries were performed by the same surgeon using comprehensive LND,covering lymph nodes at the renal hilum,para-caval,retro-caval,inter-aortocaval and aortic bifurcation areas.Results All 26 surgeries were successfully completed without conversion to open surgery.The average operation time was 84.5 minutes(range:63.0-110.0 minutes),and the average blood loss was 75.3 ml(range:20.0-180.0 ml).The drainage tube was left in place for an average of 5.8 days(range:4.0-20.0 days),and the hospital stay was 15.1 days(range:12.0-31.0 days).During a follow-up period of 16.8 months(range:5.0-36.0 months),there were 4 cases of recurrence,but no deaths.Pathological results showed an average of 29 lymph nodes removed(range:20-42),with an average of 2.1 positive lymph nodes(range:0-15),and a lymph node density of 5.6％(range:0-25.0)％.Conclusions The application of com-prehensive LND in laparoscopic radical nephroureterectomy for renal pelvis cancer is safe and feasi-ble,effectively controlling the tumor with a low complication rate.This technique offers a more extensive tumor clearance by thoroughly removing all lymph nodes and fatty tissue around the kidney.However,further large-scale,long-term follow-up studies are needed to verify its effectiveness in long-term tumor control.
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