经尿道输尿管口及周围膀胱壁加肾输尿管切除治疗肾盂移行细胞癌

Transurethral excision of bladder cuff combined with retroperitoneal nephroureterectomy for transitional cell carcinoma of renal pelvis

目的探讨治疗肾盂移行细胞癌的新方法及疗效。方法总结2003年1月至2006年3月收治的12例患者的临床资料。病例均采用经尿道输尿管口及周围膀胱壁袖套状切除加腰部斜切口肾输尿管全切术。合并膀胱肿瘤及腺性膀胱炎者同期行汽化电切处理(TUEVBt)。术后1周拔除导尿管开始膀胱灌注化疗。半年一次膀胱镜检。结果全部病例均一期愈合,无出血、感染、漏尿等并发症发生。病理证实均为肾盂移行细胞癌Ⅰ-Ⅲ级。1例术后9个月膀胱肿瘤复发行TUEVBt。现患者均健在。结论该法操作简单,疗效好,创伤小,并发症少,恢复快,可同时处理膀胱其他疾患,是治疗肾盂移行细胞癌的良好术式。

Objective To study a way to treat transitional cell carcinoma of renal pelvis and evaluate the effect Methods Clinical data of 12 cases were analysed retrospectively from Jan. 2003 to March 2006. All patients underwent transurethral excision of bladder cuff and retroperitoneal nephroureterectomy. The patients with bladder tumor or cystitis glandularis were treated by TUEV-Bt synchronously. One week after operation, the catheter was pulled out and intravesical chemotherapy was performed. All patients received cystoscopy every half a year. Results All patients gained one-stage recovery; there were no complications such as bleeding, infection and urine leakage. The pathological results were grade Ⅰ-Ⅲ of transitional cell carcinoma of renal pelvis. 1 case recurred after 9 months and received TUEV-Bt. Up to now, all patients survived. Conclusion This method is advantageous to treat transitional cell carcinoma of renal pelvis owing to its simple operation, small wound, fewer complications and better effect.