输尿管镜Nd：YAG激光治疗早期输尿管癌——附5例报告

Transureteroscopic Nd:YAG Laser Therapy for Early Ureteral Cancer

目的总结输尿管镜Nd:YAG激光治疗早期输尿管癌的疗效。方法输尿管镜活检病理检查确诊为输尿管移行细胞癌Ⅰ级患者5例,年龄49～70岁。采用功率为30 W、光纤直径为400μm、时间为2 s的Nd:YAG激光以接触式切除肿瘤,术后系统膀胱灌注化疗。结果术后随访1～6年。1例术后1年发现膀胱肿瘤,再次行激光治疗。其余4例无复发。结论输尿管镜结合Nd:YAG激光诊治早期输尿管癌安全、疗效确切。

Objective To discuss the diagnosis and treatment of early ureteral cancer with contact Nd ： YAG laser transureteroscopic manipulation. Methods Five cases （2 men and 3 women） of early ureteral cancer were reported. The age was 49-70. Three of them were solitary kidney （one with congenital solitary kidney, and two after radical nephroureterectomy and a sleeve resection of bladder ）. Four patients had hematuria or lumbago respectively, the other one had no symptom. Pathological findings confirmed the diagnosis of transitional cell cancer of ureter. All of the patients were treated with contact Nd：YAG laser, intravesical instillation was performed after operation. Results The patients were followed up for 1-6 years. Bladder tumor was found in one case, and was treated with contact Nd ： YAG laser again. The others were free from tumor. Conclusions The treatment of early ureteral cancer with contact Nd ： YAG laser transureteroscopic manipulation is safe and effective.