输尿管软镜技术在疑似肾盂恶性肿瘤诊断中的临床应用

Clinical observation of flexible ureteroscopy in the diagnosis of suspected renal pelvic carcinoma

目的探讨并评价疑似肾盂恶性肿瘤诊断过程中实施输尿管软镜检查的意义,有效提高诊治率。方法2016年10月至2017年3月收治3例以血尿为主诊经由外院转院患者,入院前均在外院行CT尿路成像检查、膀胱镜检查及输尿管镜检查,结果均提示阴性。入院后通过被动扩张输尿管后行输尿管软镜检查进一步明确诊断并采取后续治疗措施。结果3例患者中有2例在镜下发现乳头状肿瘤,其中1例直接一期行肾输尿管全长切除术,1例待病理明确诊断后行肾输尿管全长切除术。另外1例仅显示肾盂黏膜粗糙,术中以取石网篮行多处活检,后病理同样提示肾盂恶性肿瘤。结论输尿管软镜技术在疑似肾盂恶性肿瘤中的诊断率确实,可行性高,值得临床中推广。

Objective To investigate and evaluate the clinical significance of flexible ureteroscopy in patients with suspected renal pelvic carcinoma, and improve the diagnostic rate. Methods Three cases of computed tomography urography negative patients with hematuria from October 2016 to March 2017 was retrospectively reviewed, the results by rigid ureteroscopy and cystoscopy were also negative. All patients received flexible ureteroscopy in our department to confirm the diagnosis and take the relevant treatment. Results Two patients were found with tumors of renal pelvis, and underwent radical resection of renal pelvic carcinoma by pathologic examination, the other patient was considered roughness mucosa in pelvic, and the result in biopsy was also malignant tumor. Conclusions Flexible ureteroscopy is a effective, safe, highly probable treatment for the diagonosis in patients with suspected renal pelvic carcinoma.