脐尿管癌的临床诊断及治疗

Clinical analysis of 13 cases of urachal carcinoma

目的探讨脐尿管癌的临床诊断及治疗方法。方法回顾性分析北京友谊医院泌尿外科及北京市房山区第一医院泌尿外科1990—2011年收治的13例脐尿管癌患者的临床资料，并结合文献讨论其临床诊断与治疗方法。结果13例患者中12例出现无痛性肉眼血尿，B超及cT均提示膀胱顶壁或前壁外囊性或囊实性肿物。9例患者行扩大性膀胱部分切除术，3例行膀胱全切术；3例术后行化疗，1例单纯行化疗。随访2个月-11年，9例单纯行手术治疗的患者中，6例2年内死于肿瘤复发转移，1例术后30个月死于肿瘤复发并远处转移，2例术后分别随访至今3年及6年肿瘤无复发；3例行手术加化疗患者中1例术后，1年复发转移死亡，2例术后分别随访至今4年及6年肿瘤无复发；1例单纯化疗患者2个月后死于肿瘤进展。结论脐尿管癌首发症状多为无痛性肉眼血尿，手术方法以扩大性膀胱部分切除为主，术后应积极辅助化疗。

Objective To summarize the author＇ s clinical experiences in the diagnosis and treatment of urachal carcinoma. Methods Thirteen cases with urachal carcinoma from 1990 -2011 at Beijing Friendship Hospital affil- iated to Capital Medical University were retrospectively reviewed and analyzed. Results The most common com- plaint was hematuria;B ultrasonic or CT scan demonstrated a parenchyma or vesica between the bladder dome and abdominal wall. Nine patients underwent extensive pattical excision of the bladder, 3 paitents underwent radical re- section, and 4 patients received comprihensive chemotherapy. The five -year survival rate was 30.7%. Conclusion Extensive partial excision of the bladder is recommended for urachal carcinoma.