肾移植后发生双侧肾盂和输尿管移行细胞癌的探讨(附5例报告)

Bilateral pelvic and ureteral transitional cell carcinoma after kidney transplantation(Report of 5 cases)

目的:探讨肾移植术后发生双侧肾盂、输尿管移行细胞癌的临床特征。方法:报告5例肾移植后发生双侧肾盂、输尿管移行细胞癌患者的临床资料。于肾移植术后21～58个月检出,其中同时发现双侧肾盂、输尿管移行细胞癌3例,一侧移行细胞癌术后发现对侧移行细胞癌2例。2例分两次分别切除双侧肾脏、输尿管和部分膀胱壁,3例一次性切除双侧肾脏、输尿管和部分膀胱壁。术后给予丝裂霉素、吡柔比星、表阿霉素等进行膀胱灌注化疗。结果:5例均手术成功,术后继续膀胱灌注化疗,随访5～19个月无复发。结论:国人肾移植术后发生双侧肾盂、输尿管移行细胞癌并不鲜见,必须警惕;采用腹腔镜手术和下腹部开放手术切除病变,调整免疫抑制治疗方案有效。

Objective：To present our experience with bilateral pelvic and ureteral transitional cell carcinoma after kidney transplantation. Methods：From Jan 2001 to May 2006, 5 kidney recipients were detected having bilateral pelvic and ureteral transitional cell carcinoma 21-58 months after transplantation, all of them were treated surgically. Bladder chemotherapy was given to all patients. Results： All operations were successful and there was no recurrence during follow up. Conclusions：Bilateral pelvic and ureteral transitional cell carcinoma can be treated laparoscopically and the incision is important for the success of operation.