{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T22:17:28Z","timestamp":1758925048897,"version":"3.37.3"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Bolsa de Doutoramento Jos\u00e9 de Mello Sa\u00fade"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Upper urinary tract urothelial carcinomas are usually managed by radical nephroureterectomy (RNU), often followed by intravesical chemotherapy to minimize recurrence. Open surgery is the gold standard procedure for RNU, but it associates with high morbidity, and it has been increasingly replaced by minimally invasive strategies, such as laparoscopy and endoscopy. Although effective, endoscopic ureteral excision leaves the bladder unsutured, increasing the risk of tumor spillage, and precluding the immediate administration of intravesical chemotherapy. Here we describe a new method to close the bladder wall after ureteral excision, using barbed sutures via the endoscopic access. Our results in 8 female pigs demonstrate that this method is effective to close the bladder wall. The procedure was completed in a median time of 24\u2009min, and no adverse events were registered in the follow-up or at the three-week necropsy. This technique improves a previous approach described by our group because the device is more flexible and allows to tie the knots inside the bladder. Barbed sutures have been used in the clinical practice for other types of surgeries, and therefore this method can further be adapted to human patients with no safety concerns. Its use may allow to administer intravesical chemotherapy, which reduces tumor recurrence and improves patient outcomes.<\/jats:p>","DOI":"10.1038\/s41598-019-54304-w","type":"journal-article","created":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T11:03:32Z","timestamp":1575975812000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["New endoscopic procedure for bladder wall closure: results from the porcine model"],"prefix":"10.1038","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1761-8080","authenticated-orcid":false,"given":"Carlos","family":"Oliveira","sequence":"first","affiliation":[]},{"given":"Alexandre A.","family":"Barros","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4295-6129","authenticated-orcid":false,"given":"Rui L.","family":"Reis","sequence":"additional","affiliation":[]},{"given":"Jorge","family":"Correia-Pinto","sequence":"additional","affiliation":[]},{"given":"Est\u00eav\u00e3o","family":"Lima","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2019,12,10]]},"reference":[{"key":"54304_CR1","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1016\/j.eururo.2015.06.044","volume":"68","author":"M Roupr\u00eat","year":"2015","unstructured":"Roupr\u00eat, M. et al. European Association of Urology Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma: 2015 Update. Eur. Urol. 68, 868\u2013879 (2015).","journal-title":"Eur. Urol."},{"key":"54304_CR2","doi-asserted-by":"publisher","first-page":"3613","DOI":"10.1245\/s10434-012-2453-9","volume":"19","author":"P Colin","year":"2012","unstructured":"Colin, P. et al. Influence of positive surgical margin status after radical nephroureterectomy on upper urinary tract urothelial carcinoma survival. Ann. Surg. Oncol. 19, 3613\u20133620 (2012).","journal-title":"Ann. Surg. Oncol."},{"key":"54304_CR3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1111\/j.1464-410X.2010.09835.x","volume":"108","author":"V Ph\u00e9","year":"2011","unstructured":"Ph\u00e9, V., Cussenot, O., Bitker, M.-O. & Roupr\u00eat, M. Does the surgical technique for management of the distal ureter influence the outcome after nephroureterectomy? BJU Int. 108, 130\u2013138 (2011).","journal-title":"BJU Int."},{"key":"54304_CR4","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.eururo.2016.05.041","volume":"71","author":"M Babjuk","year":"2017","unstructured":"Babjuk, M. et al. EAU Guidelines on Non\u2013Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur. Urol. 71, 447\u2013461 (2017).","journal-title":"Eur. Urol."},{"key":"54304_CR5","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1111\/j.1464-410X.2008.07950.x","volume":"103","author":"M Waldert","year":"2009","unstructured":"Waldert, M., Remzi, M., Klingler, H. C., Mueller, L. & Marberger, M. The oncological results of laparoscopic nephroureterectomy for upper urinary tract transitional cell cancer are equal to those of open nephroureterectomy. BJU Int. 103, 66\u201370 (2009).","journal-title":"BJU Int."},{"key":"54304_CR6","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.euf.2017.10.003","volume":"5","author":"B Peyronnet","year":"2019","unstructured":"Peyronnet, B. et al. Oncological Outcomes of Laparoscopic Nephroureterectomy Versus Open Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: An European Association of Urology Guidelines Systematic Review. Eur. Urol. Focus 5, 205\u2013223 (2019).","journal-title":"Eur. Urol. Focus"},{"key":"54304_CR7","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.eururo.2012.04.052","volume":"65","author":"E Xylinas","year":"2014","unstructured":"Xylinas, E. et al. Impact of Distal Ureter Management on Oncologic Outcomes Following Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma. Eur. Urol. 65, 210\u2013217 (2014).","journal-title":"Eur. Urol."},{"key":"54304_CR8","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.eururo.2009.12.032","volume":"57","author":"W-M Li","year":"2010","unstructured":"Li, W.-M. et al. Oncologic outcomes following three different approaches to the distal ureter and bladder cuff in nephroureterectomy for primary upper urinary tract urothelial carcinoma. Eur. Urol. 57, 963\u2013969 (2010).","journal-title":"Eur. Urol."},{"key":"54304_CR9","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1159\/000350508","volume":"91","author":"D Fang","year":"2013","unstructured":"Fang, D. et al. Prophylactic Intravesical Chemotherapy to Prevent Bladder Tumors after Nephroureterectomy for Primary Upper Urinary Tract Urothelial Carcinomas: A Systematic Review and Meta-Analysis. Urol. Int. 91, 291\u2013296 (2013).","journal-title":"Urol. Int."},{"key":"54304_CR10","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/j.eururo.2011.05.064","volume":"60","author":"T O\u2019Brien","year":"2011","unstructured":"O\u2019Brien, T. et al. Prevention of Bladder Tumours after Nephroureterectomy for Primary Upper Urinary Tract Urothelial Carcinoma: A Prospective, Multicentre, Randomised Clinical Trial of a Single Postoperative Intravesical Dose of Mitomycin C (the ODMIT-C Trial). Eur. Urol. 60, 703\u2013710 (2011).","journal-title":"Eur. Urol."},{"key":"54304_CR11","doi-asserted-by":"publisher","first-page":"1422","DOI":"10.1200\/JCO.2012.45.2128","volume":"31","author":"A Ito","year":"2013","unstructured":"Ito, A. et al. Prospective Randomized Phase II Trial of a Single Early Intravesical Instillation of Pirarubicin (THP) in the Prevention of Bladder Recurrence After Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma: The THP Monotherapy Study Group Trial. J. Clin. 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