以泌尿系症状首诊的乙状结肠癌临床诊治分析

Analysis about the diagnosis and treatment of sigmoid cancer manifested with urinary system symptoms at the first sight

目的探讨乙状结肠癌侵犯泌尿系统而以泌尿系症状为首诊症状病例的诊断与治疗。方法根据患者泌尿系的不同症状分成两组:(1)以膀胱刺激症状为主的为A组,共16例,手术中证实为乙状结肠癌侵犯膀胱形成结肠膀胱瘘,进行乙状结肠癌根治性切除联合膀胱部分切除;(2)以血尿症状为主的为B组,共9例,手术中证实为乙状结肠癌侵犯左侧输尿管,行乙状结肠癌根治性切除联合输尿管部分切除。结果所有病例首先出现大便习惯或性状改变,然后才出现泌尿系症状,根治性联合脏器切除仍有较好的5年生存率。结论重视泌尿系症状出现前的大便形状及习惯改变是早期诊断的关键,乙状结肠癌侵犯泌尿系应争取进行根治性联合脏器切除。

Objective To investigate the diagnosis and treatment of the sigmoid cancer manifested with urinary system symptoms at the first sight..Methods 2 groups had been divided accorded to the different symptoms,A group had 16 cases,including of 13 females and 4 males,aged 36 to 65 years old,and urinary system symptom was irritation symptoms of bladder,the sigmoid cancer infiltrated bladder was confirmed during the operation,and sigmoidectomy and partial cystectomy were executed;B group had 9 cases,including of 2 females and 7 males,aged 40 to 72 years old,and urinary system symptom were hematuria,the sigmoid cancer infiltrated the ureter were confirmed during operation,and sigmiodectomy and partial ureterctomy were executed.Results The bowel habit and character changed before the urinary system symptoms in all cases,and radical multi-visceral resection had preferable survival rat of 5 years.Conclusion Attach importance to the bowel habit and character change before the urinary system symptoms is the key to early diagnosis,the sigmoid cancer infiltrate the urinary system must try for radical multi-visceral resection.