{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:23:51Z","timestamp":1761744231797,"version":"build-2065373602"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the Agarwal loop\u2010ligation technique for the management of the distal ureter during laparoscopic radical nephroureterectomy (LRNU) for upper tract urothelial carcinoma (UTUC) and report on long\u2010term oncological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      In the Agarwal loop\u2010ligation technique, the distal ureteric stump is controlled using endoscopic Endoloop\n                      <jats:sup>\u00ae<\/jats:sup>\n                      or PolyLoop\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ligation to ensure\n                      <jats:italic>en bloc<\/jats:italic>\n                      excision of the bladder cuff and prevent spillage of upper tract urine into the perivesical space. A retrospective review of the medical records of 76 patients who underwent the Agarwal loop\u2010ligation technique for UTUC at participating centres from July 2004 to December 2017 was performed. Data collected included demographics, perioperative, and long\u2010term oncological outcomes. Survival was calculated using Kaplan\u2013Meier survival analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Limitations<\/jats:title>\n                    <jats:p>A total of 76 patients were included. The median age was 71.5\u00a0years and median operative time was 4.3\u00a0h. The intramural ureter and bladder cuff were completely excised in all patients. Distal surgical margins were clear in all, with only two patients found to have tumour extending to the circumferential surgical margin. There were no cases of perivesical recurrence or port\u2010site metastasis. The 5\u2010year bladder, local, and contralateral recurrence\u2010free survival was 59.6%, 89.0% and 93.5%, respectively. Metastasis\u2010free survival at 5\u2010years was 73.5%. The 5\u2010year overall survival and cancer\u2010specific survival rates were 70.3% and 84.7%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We have described the Agarwal loop\u2010ligation technique for the management of the distal ureter in LRNU. This technique complies with oncological principles outlined in the European Association of Urology guidelines, which minimises tumour spillage. Long\u2010term oncological outcomes are satisfactory, with no cases of perivesical recurrence detected in this series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15321","type":"journal-article","created":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T19:55:33Z","timestamp":1608926133000},"page":"112-121","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010term oncological outcomes of the Agarwal loop\u2010ligation technique for management of the distal ureter during laparoscopic radical nephroureterectomy"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2717-9085","authenticated-orcid":false,"given":"Venetia","family":"Hoe","sequence":"first","affiliation":[{"name":"Department of Urology Western Health Melbourne Vic. Australia"},{"name":"University of Melbourne Parkville Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry H.","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Crozier","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2605-0463","authenticated-orcid":false,"given":"Abbie","family":"Kanagarajah","sequence":"additional","affiliation":[{"name":"Department of Urology Western Health Melbourne Vic. Australia"},{"name":"University of Melbourne Parkville Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Florescu","sequence":"additional","affiliation":[{"name":"Department of Urology The Royal Melbourne Hospital Melbourne Vic. 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