输尿管残端癌15例诊治分析

Analysis of diagnosis and treatment of 15 cases with carcinoma of the ureteral stump

目的 :探讨输尿管残端癌的临床特点及治疗方法。方法 :总结输尿管残端癌 1 5例 ,全部行输尿管残端及膀胱部分切除术 ,术后膀胱灌注化疗。结果 :1 5例患者术后病理均诊断为乳头状移行细胞癌 ,随访时间 8个月至 5年 ,其中术后 3个月膀胱肿瘤复发 1例 ,术后2 6月膀胱肿瘤复发 2例 ,术后 3年膀胱肿瘤复发 4例 ,均存活 5年以上。结论 :输尿管残端癌应以早期手术为主 ,切除范围包括输尿管残端及输尿管口周围直径 2 cm膀胱壁 ,术后常规膀胱内灌注化疗 ,肿瘤若无法完全切除 ,可行化疗或放疗 ,以减少和预防输尿管残端癌的发生。

Objective:To discuss the clinical features and the treatment of carcinoma of the ureteral stump.Methods:The clinical data of 15 cases with carcinoma of the ureteral stump treated by ablation of ureteral stump and the partial resection of bladder were analyzed,after operation they were treated by the chemotherapy of bladder perfusion.Results:The 15 cases were all diagnosed as mastoid transitional cell carcinoma of the ureteral stump by afterpathology,then they were successfully followed up from 8 months to 5 years.They included 1 cases with recurred bladder cancer 3 months after operation,2 cases with recurred bladder cancer 26 months after operation and 4 cases with recurred bladder cancer 3 years after operation.All patients survived for more than 5 years.Conclusion:Carcinoma of the ureteral stump should be given priority to early operation,the range of excision included ureteral stump and the bladder wall diameter 2cm around the ureteric orifice. Chemotherapy of bladder perfusion after operation should be routinely applied. If the tumour can not be totally excised, chemotherapy or radiotherapy is feasible,which can decrease and prevent the occurrence of carcinoma of the ureteral stump.