经尿道输尿管口环切与肾输尿管全长切除术治疗肾盂癌的疗效观察

The Treatment of transitional cell carcinoma of renal pelvis with total nephrouretorectomy combined with transurethral excision of the bladder cuff

目的探讨经尿道输尿管口环切与肾输尿管全长切除术治疗肾盂癌的方法及疗效。方法采用先经尿道将输尿管口环状汽化电切,然后经腰部斜切口行肾输尿管全切的手术方法,其中合并膀胱肿瘤1例、腺性膀胱炎2例,同期行汽化电切处理。术后1周拔除导尿管开始膀胱灌注化疗,半年1次膀胱镜检。结果14例手术均顺利完成,病理证实为肾盂移行细胞癌Ⅰ-Ⅲ级。术后未出现出血、感染、尿漏等并发症,平均手术时间120分钟,术后平均住院时间8天。术后随访3-18个月,1例术后9个月经B超和膀胱镜检查膀胱肿瘤复发行TUEVB t,现患者均健在。结论尿道输尿管口环切与肾输尿管全长切除术治疗肾盂癌操作相对简单,疗效好,创伤小,并发症少,恢复快,是治疗肾盂移行细胞癌的良好术式。

Objective To probe into the surgical techique of the treatment of transitional cell carcinoma of renal pelvis and ev uate its clinical effect. Methods Clinical data of 14cases were analysed retrospectively from 2003 to 2007. All patients underwent ra surethral excision of bladder cuff and retroperitoneal nephroureterectomy. The patients with bladder tumor or cystitislandularis were tre ted by TUEV2Bt synchronously. One week after operation, the catheter was pulled out and intravesical chemotherapy was performed. 1 patients received cystoscopy every half a year. Results All patients gained one stage recovery, the pathological results were grade I -Ⅲof transitional cell carcinoma of renal pelvis. There were no complications such as bleeding, infection and urine leakage. The mean operation time was 120 minutes and the average time of hospitalization stay after operation was 8 days. All the patients had been follow, up 3 to 18 months. 1 case recurred after 9 months and received TUEV2Bt. Up to now, all patients survived. Conclusion This meth（ is advantageous to treat transitional cell carcinoma of renal pelvis owing to its simple operation, small wound, fewer complications and better effect.