Minimally Invasive Radical Nephroureterectomy: 5-Year Update of Techniques and Outcomes

SIMPLE SUMMARY: Minimally invasive radical nephroureterectomy is gaining momentum among upper tract urothelial carcinoma management by offering oncological radicality and less surgical morbidity. Long-term oncological outcomes suggest that it is a safe and effective treatment option for upper tract urothelial cancer. ABSTRACT: The gold standard treatment for non-metastatic upper tract urothelial cancer (UTUC) is represented by radical nephroureterectomy (RNU). The choice of surgical technique in performing UTUC surgery continues to depend on several factors, including the location and extent of the tumor, the patient’s overall health, and very importantly, the surgeon’s skill, experience, and preference. Although open and laparoscopic approaches are well-established treatments, evidence regarding robot-assisted radical nephroureterectomy (RANU) is growing. Aim of our study was to perform a critical review on the evidence of the last 5 years regarding surgical techniques and outcomes of minimally invasive RNU, mostly focusing on RANU. Reported oncological and function outcomes suggest that minimally invasive RNU is safe and effective, showing similar survival rates compared to the open approach.