腔内激光手术治疗肾盂输尿管肿瘤

Endoscopic treatment of upper urinary tract urothelial carcinoma by 980nm laser

目的:通过对无法行根治性手术的上尿路上皮肿瘤患者进行腔内红激光治疗情况进行总结,评价该术式的有效性与安全性。方法:对于我院2013年1月到2016年6月期间收治的肾盂、输尿管肿瘤,其中13例行腔内激光手术治疗,分别就术中情况、术后并发症及疗效进行总结。结果:13例患者中,肾盂肿瘤行经皮肾镜激光手术9例,输尿管肿瘤行输尿管镜激光手术4例,平均手术时间分别为(47.22±6.25)min、(25.0±4.84)min;平均出血量分别约为(133.33±24.94)ml、(40.0±7.07)ml;血尿及肾积水情况得到控制,5/13例呈现局部进展,1/13例术后10个月死亡;未出现严重并发症。结论:对于特殊情况下的肾盂、输尿管肿瘤患者,腔内激光手术具有创伤小,止血效果好,可以姑息性切除肿瘤,降低肿瘤负荷,保护肾脏功能,也能减缓肿瘤进展,可以作为这一类患者的首选治疗方案。

Objective：To evaluate the effectiveness and safety of endoscopic treatment of upper urinary tract urothelial carcinoma by 980 nm laser.Methods：The operation,complication,progression and prognostic features of 13 patients with upper urinary tract urothelial carcinoma,who were undergone endoscopic treatment by 980 nm laser,were evaluated.Results：In these cases,9 with renal pelvic carcinoma were treated with PCNL,the other 4 were treated with ureteroscopy.Average operation time were separately （47.22±6.25）min,（25.00±4.84）min,average blood loss were separately （133.33±24.94）ml,（40.00±7.07）ml.Symptoms of hematuria and hydronephrosis were contraled.Locally recurrent emerged in 5/13 cases and 1/13 case died.None of serious complication occurred.Conclusion：Endoscopic treatment by 980 nm laser is a safe and effective therapy method of upper urinary tract urothelial carcinoma because of its minimally invasive,controlling of hematuria and hydronephrosis,postponing progression.