双侧上尿路肿瘤的治疗方法分析与评估（附2例报告）

The treatment analysis of Synchronous bilateral transitional cell carcinoma of the upper urinary tracts （Report of 2 Cases）

目的 探讨双侧上尿路同时发生恶性肿瘤的治疗方法及有效性评价.方法 报告2013年1月-2013年2月本院收治的2例双侧上尿路同时发生肿瘤患者的临床资料,2例均行一侧肾输尿管全长切除术,对侧保留肾脏的手术.其中1例为输尿管膀胱再吻合术,1例为输尿管镜下肿瘤切除术.结果 术后病理结果均提示移行细胞癌.目前2例患者均在随访中,其中1例术后6个月及8个月分别出现膀胱肿瘤复发,后于2013年10月行膀胱根治性切除术;1例未见肿瘤复发.结论 对于双侧同时存在尿路上皮肿瘤的患者,可根据实际情况选择一侧肾输尿管全长切除＋对侧保留肾脏的手术方法,此种治疗方式术后花费低、患者主观生存质量较高,值得临床推荐.当然术后有效的随访必不可少.

Objectives To investigate the treatment methods and feasibility analysis for bilateral upper urinary tract transitional cell carcinoma.Methods The clinical data of 2 cases from January 2013 to February 2013 with transitional cell carcinoma of synchronous bilateral upper urinary tracts were reported.Both were received unilateral nephroureterectomy and contralateral organ-preserving surgery.Including partial ureterectomy and reimplantation and endoscopic resection.Results The result of the pathology was all transitional cell carcinoma.In follow-up,1 case generated bladder tumor after operation in six months later and eight months later,then was received radical cystectomy in October 2013,1 case was seen without tumor recurrence.Conclusions As for patients with synchronous bilateral transitional cell carcinoma of the upper urinary tracts,unilateral nephroureterectomy and contralateral organ-preserving surgery could be taken for the sake of kidney function.It is worthy to be recommended because of the lower postoperative expenses and higher life quality.Besides,intensive monitoring should be taken after operation.