后腹腔镜辅助小切口肾输尿管及膀胱袖状切除术23例报告

Radical nephroureterectomy and bladder cuff excision with short incision assisted by retroperitoneal laparoscopy—report of 23 cases

目的：探讨后腹腔镜辅助小切口肾输尿管及膀胱袖状切除术的有效性和安全性。方法2011年1月—2013年1月，采用后腹腔镜辅助小切口为23例原发性输尿管肿瘤患者行肾输尿管及膀胱袖状切除术。男15例，女8例，平均62．5岁，其中左侧14例，右侧9例，肿瘤位于下段18例，上段5例。结果23例手术均获成功，手术时间180～300 min，平均200 min，术中出血50～150 mL，平均80 mL，术后平均住院9 d，无严重并发症发生。随访6～44个月，无肿瘤复发。结论采用后腹腔镜辅助小切口肾输尿管及膀胱袖状切除术治疗输尿管肿瘤具有患者创伤小、出血少、手术时间短、并发症少、切除更完全等优点，是上尿路肿瘤的一种安全有效的微创治疗方法。

Objective To evaluate the safety and effectiveness of radical nephroureterectomy and bladder cuff excision with short incision assisted by retroperitoneal laparoscopy.Methods Twenty-three patients with ureteral tumor underwent radi-cal nephroureterectomy and bladder cuff excision with short incision assisted by retroperitoneal laparoscopy from Jan 2011 to Jan 2013.Of these patients, there were 15 males and 8 females with a mean age of 62.5 years old.Fourteen tumors were at left side and 9 were at right.Five cases were carcinoma of superior segment and 18 cases were carcinoma of distal seg-ment.Results all operations were successful.The mean operation time was 200 min （range from 180 to 300 min）.The in-traoperative blood loss was 50-150 mL （ mean 80 mL） , and the mean postoperative hospitalization was 9 d.No severe complications occurred.There was no recurrence with a follow-up of 6-44 months.Conclusion Radical nephroureterec-tomy and bladder cuff excision with short incision assisted by retroperitoneal laparoscopy has advantages of minimal inva-sion, less blood loss, fewer complications, short hospitalization and complete resection for carcinoma in ureter.It is a safe, effective and minimally invasive treatment for ureter urothelial carcinoma.