后腹腔镜联合下腹部小切口上尿路上皮肿瘤根治术

Retroperitoneal laparoscopy combined with small incision in the treatment of upper urinary tract urothelial carcinoma

目的总结后腹腔镜联合下腹部小切口上尿路上皮肿瘤根治术的经验。方法回顾分析后腹腔镜联合下腹部小切口根治上尿路上皮肿瘤17例的临床资料。男8例,女9例,年龄28～77岁,平均年龄63岁,右侧10例,左侧7例。肾盂癌10例,输尿管癌7例,其中上段1例,中段4例,下段2例。结果 17例根治性手术均获成功,手术平均时间为224min,1例形成局部皮下气肿,无一例输血,无严重并发症发生,术后平均住院天数为13d,随访1～28个月均未发生肿瘤转移及切口种植。结论后腹腔镜联合下腹部小切口上尿路上皮肿瘤根治术,具有损伤小,恢复快等优点,具有良好的应用前景。

Objective The traditional regimen for the treatment of upper urinary tract urothelial carcinoma including ureteronephrectomy plus partial cystectomy,with a long incision,extend hospital stay and slow revovery.We summerize the experience of retroperitoneal laparoscopy combined with small incision in the treatment of upper urinary tract urothelial carcinoma.Methods We reviewed retrospectively 17 patients with upper urinary tract urothelial carcinoma,8 male,9 female patients with a mean age of 63 years（range 28 to 77 years）,the renal lesions located in left side in 7 patients,right side in 10 patients,10 cases were renal pelvic cancer,7 were ureteral cancer,of the 7 patients,1,4 and 2 cases of tumor was located in the proximal,middle and distal of the ureter,respectively.Results 17 cases of radical operations were finished successfully without serious complications or blood transfusion,only one local subcutaneous emphysema occured.Average operation time was 224 min.The averagy hospital stay after operation was 13 days.There was no tumor matastasis and incision port implantation during 1-28 month followup.Conclusions The advantages of the retroperitoneal laparoscopy combined with small incision for upper urinary urothelial tract carcinoma are microtrauma,rapid recovery,and has a good prospect in the future.