摘要
目的：总结腹膜后腹腔镜联合尿道电切镜行肾输尿管切除并膀胱袖状切除术治疗上尿路移行细胞癌的临床经验。方法：回顾分析9例肾盂癌、8例输尿管癌患者的临床资料。术中先用电切镜经尿道袖状分离输尿管管口及壁内段,再切除肾、输尿管,并记录相关指标,术后常规用丝裂霉素或吡柔比星灌注膀胱。结果：16例手术顺利完成,1例因右肾切除时损伤下腔静脉而中转开放手术。手术时间135-250min,平均190min;术中失血60-1 000ml,平均150ml;引流管放置2-5d,平均3.5d;尿管留置7-9d,平均8d;术后住院8-14d,平均9.4d。术后随访3-32个月,1例输尿管癌患者于术后7个月复发膀胱肿瘤;1例肾盂癌患者术后17个月发现左肺转移。结论：腹膜后腹腔镜联合尿道电切镜行肾输尿管切除并膀胱袖状切除术治疗上尿路移行细胞癌安全、有效,实用性强,值得推广应用。
Objective：To summarize the clinical experience of retroperitoneal laparoscopic and urethral resectoscopic nephroureterectomy and bladder sleeve resection for upper urinary transitional cell carcinoma.Methods：The clinical data of 9 cases of renal pelvic carcinoma and 8 cases of ureteral carcinoma were retrospectively analyzed.The ureteral orifice and intramural part was sleeve-separated by trans-urethral resectoscopy.Then kidney and ureter were resected.Relevant data were recorded.After operation,the urinary bladder was irrigated with mitomycin or pirarubicin routinely.Results：Sixteen operations were successful,1 case of inferior vena cava was injured when right kidney was resected,and was converted to open surgery.The mean operative time was 190min（range 135-250min）,the mean blood loss was 150ml（range 60-1 000ml）.The drainage tube was removed 2-5d（mean 3.5d） later,and the urinary canal was removed 7-9d（mean 8d） later.The mean postoperative hospital stay was 9.4d（range 8-14d）.During he follow up of 3-32 months,recurrent urinary bladder occurred in a patient with ureteral carcinoma 7 months later,and left pulmonary metastasis occurred in a patient with renal pelvic carcinoma 17 months later.Conclusions：The retroperitoneal laparoscopic and urethral resectoscopic nephroureterectomy and bladder sleeve resection is safe and effective in treatment of upper urinary transitional cell carcinoma,and is worth popularization.
出处
《腹腔镜外科杂志》
2011年第6期416-418,共3页
Journal of Laparoscopic Surgery
关键词
肾盂肿瘤
输尿管肿瘤
癌
移行细胞
腹腔镜检查
Kidney pelvis neoplasms
Ureteral neoplasms
Carcinoma
transitional cell
Laparoscopy
