经尿道电气化切除下段输尿管在上尿路肿瘤治疗中的应用

Nephrectomy combined with transurethral electrovaporization of distal ureteral segment for treatment of renal pelvic and ureteral tumors

目的 探讨经尿道电气化切除下段输尿管在上尿路肿瘤治疗中的应用价值。方法 采用肾切除 +经尿道电气化切除下段输尿管治疗上尿路移行细胞癌 2 6例。结果 2 6例手术时间 1.5～ 2 .5h ,平均 2h ,腹膜后引流管留置 2 4～ 4 8h ,导尿管留置 3～5d ,术后未见出血、尿瘘、感染及切口肿瘤种植等。 2 2例获得随访 4～ 74个月 ,平均 38个月 ,3例手术后 6～ 9个月发生膀胱移行细胞癌并行膀胱部分切除或TUR Bt术 ,患侧输尿管走行区及输尿管膀胱开口部未见肿瘤复发。结论 该手术方法创伤小 ,术后并发症少 ,效果良好 ,是治疗上尿路肿瘤的有效手术方法。

Objective To improve surgical technique in the treatment of renal pelvic and ureteral tumors. Methods From Sep. 1996 to June 2002, nephrectomy combined with transurethral electrovaporization of distal ureteral segment was carried out on 26 cases of renal pelvic or ureteral tumors and 22 of them were followed up for 4 to 74 months with a mean of 38 months. Results No surgical complications were found. On cystoscopy, no tumor occurrence was found at the site of the excised ureteral orifice. However, tumor growth was noted somewhere in the bladder in 3 out of 22 (14%). Conclusion The modified surgical technique is effective for the treatment of pelvic and ureteral cancer with less trauma to patients and fewer complications.