Upper tract urothelial carcinoma has a high recurrence rate after endoscopic treatment. Immediate post-operative topical chemotherapy may reduce recurrences, as in bladder cancer.
A reliable delivery method to the upper tract does not exist. We propose a new infusion pump technology for the delivery of topical chemotherapeutic agents to the upper tract. Under general anesthesia, contrast is infused into the upper collecting system using a standard infusion pump. An optimal infusion rate is determined based on fluoroscopic filling of the upper collecting system and transduced intra-pelvic pressures. Using this rate, the infusion is repeated post-operatively with chemotherapeutic agent. We report one case of successful execution to demonstrate proof of concept. We are the first to describe retrograde upper tract chemotherapeutic irrigation with an IV pump. This technique may facilitate and standardize the delivery of intracavitary chemotherapy. Further investigation to determine whether it translates into improved safety and/or efficacy is warranted.
Written by:
Maurice MJ, Madi R, Chuang D, Abouassaly R. Are you the author?
University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Urology Institute, Cleveland, Ohio, United States.
Reference: J Endourol. 2012 Dec 20. Epub ahead of print.
doi: 10.1089/end.2012.0608
PubMed Abstract
PMID: 23253199
UroToday.com Endourology Section
