摘要
目的总结输尿管镜下钬激光切除纤维上皮性息肉的经验。方法输尿管纤维上皮性息肉患者5例，息肉根部位于输尿管上段2例、中段2例、下段I例。息肉长3～16cm，其中息肉自输尿管口部分脱入膀胱者2例。患侧腰痛者3例、血尿者4例、体检发现肾积水就诊者1例。均行输尿管镜下钬激光息肉切除，其中2例脱入膀胱者先行经尿道部分肿物切除。术后均留置双J管，6～8周拔除。结果5例手术均顺利完成，术中无并发症。术后病理报告组织中央见血管纤维束，大量纤维组织，散在炎性细胞浸润，表面移行上皮增生，部分黏膜下有移行细胞团，为纤维上皮性息肉。术后平均住院3（2～5）d。5例平均随访24（3～51）个月，均无复发；1例术后3个月发现输尿管狭窄，再次行输尿管镜下钬激光狭窄内切开术治愈。结论腔内手术是治疗输尿管纤维上皮性息肉的有效方法，具有损伤小、并发症少、恢复快的特点。钬激光可以采用更小口径的输尿管镜以及输尿管软镜，提高了手术成功率。
Objective To report the experience on the ureteroscopic treatment of ureteral fibro epithlial polyp by Hohnium：YAG laser resection. Methods Of five cases, the polyp was located in the upper 1 third of the ureter in 2 cases, and in middle 1 third or ureter in 2 cases, in lower 1 third of ureter in 1 case. The length of the polyps ranged from 3 to 16 cm. Three patients presented with flank pain, 4 with hematuria and l with hydronephrosis. Five patients underwent rigid ureteroscopic treat- ment. TUR was performed in the 2 polyp cases with prolapsing from the ureteral orifice. A Holmium： YAG laser was used to resect ureteral polyps. At the end of the procedure, a 7 F double J ureteral stent was placed and indwelling for 6 8 weeks. Results All operations were successfully done. The pathologic diagnosis were fibroepithelial polyp. Histologically, the polyps were composed of a central fihrovaseular core surrounded by hyperplastie benign urotheiium. The stroma of polyp consisted of fibrous connective tissue with minimal cellular infiltration, and occasional epithelial cell nests were seen. The average length of hospital stay was 3 d （range 2 to 5）. The mean follow-up was 24 months （range 3 to 51）, and all patients remained no recurrence. One patient developed a ureteral stricture 3 months after the treatment, and relieved by endoscopic incision by Holmium： YAG laser. Conclusion Endoscopic management of ureteral fibroepithelial polyps could be a treatment modality with minimal morbidity and good treatment results.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2008年第12期836-838,共3页
Chinese Journal of Urology
关键词
输尿管疾病
息肉
输尿管镜
Ureteral diseases
Polyps
Ureteroscopes
