无瘤原则下经腹直肌旁单切口治疗输尿管癌1 7例临床分析

Rectus Beside Incision Treating 17 Cases of Carcinoma of the Ureter Under the Tumor-free Principle

目的:探讨腹直肌旁单切口治疗输尿管癌的可行性。方法:选择经腹直肌旁切口,上起肋缘下至髂前上棘内侧,末端呈弧形向内下延长。手术切除肾输尿管全长及膀胱袖套状切除,手术中强调无瘤原则。结果:本组17例病人顺利行肾输尿管及膀胱袖套状切除16例,1例因肿物侵犯髂血管不能完整切除输尿管。17例术后恢复顺利,切口无肿瘤种植发生。结论:腹直肌外缘切口避免了传统术式中需要变换体位,缩短了手术时间;并且能够充分做到无瘤原则,可以作为治疗输尿管癌的可选手术方式。

Objective：To Explore the feasibility of the rectus beside single incision in treatmenting the carcinoma of the ureter. Methods：The rectus beside incision begins from rib bow down to anterior superior spine inside,with a curved inward extension at the end, emphasizing tumor-free principle.Results：Among 17 cases,16 cases were conducted resection of kidney, ureter and bladder orificeshape cuff smoothly,only one case could not be resected because iliac blood vessel were infiltrated with ureter, all were discharged from the hospital without tumor growing around incision.Conclusion：The rectus beside incision is a good pattern to treat the carcinoma of the ureter with the tumor-free principle.