Removal of the kidney and ureter simultaneously is closely associated with nephrectomy, an operation first planned and successfully performed by Simon, in 1869. I have failed to find by frequent surveys of the literature of this subject during the past ten years any records of nephroureterectomies that necessitate alterations in the tables and case references contained in my paper read before the Southern Surgical and Gynecological Association in 1899.1 This table credited H. A. Kelly, of Baltimore, with performing the first nephroureterectomy, Dec. 18, 1895, for tuberculous ureter. During the following month the late A. J. McCosh, of New York, performed the operation for tuberculosis of the kidney.
Early in the history of this operation the two principal routes employed were the loin extraperitoneal and the transperitoneal. The greater danger of infection that frequently attends the transperitoneal route would reasonably