TECHNICAL INNOVATIONS Simultaneous radical neph lo WORLD JOURNAL OF SURGICAL ONCOLOGY

Full list of author information is available at the end of the articleBackground Radical nephroureterectomy (RNU) with distal ureter bladder cuff (DUBC) excision is the standard treatment for high-risk non-invasive and invasive upper tract tran-sitional cell carcinoma (UT-TCC), but there is no agree-ment on the ideal technique for DUBC excision [1-3]. The extravesical approach avoids repositioning the pa-tient but violates the golden rule of excising the DUBC under direct vision; conversely, the transvesical and the endoscopic approach allow DUBC excision under direct vision but require the patient to be repositioned, thus being time-consuming. Independent of the DUBC exci-sion technique, the procedure should comply with the oncological principle of preventive ureteral occlusion and en bloc specimen removal to avoid spillage and con-sequent seeding of tumor cells. To comply with the oncological principle of preventing spillage of tumor cells, we recently described a technique for transurethral distal ureter balloon occlusion before detach