关于上尿路移行上皮恶性肿瘤手术方式研究进展

Research progress of surgical methods for upper urinary transitional epithelial malignancies

上尿路移行上皮恶性肿瘤包括肾盂恶性肿瘤和输尿管恶性肿瘤。其标准术式为开放根治性肾输尿管切除术,随着腹腔镜技术不断发展,越来越多的泌尿外科医生将腹腔镜技术应用于上尿路移行上皮恶性肿瘤的治疗中,虽然腹腔镜手术较开放手术具有明显的优势,但操作技术难度较大,而机器人辅助腹腔镜技术的应用克服了许多复杂腹腔镜手术技巧的限制,从而为临床医生提供了更多的选择。除了手术时间、术中出血、手术损伤以及住院时间外,膀胱内肿瘤复发的风险同样是判断一个术式是否可行的重要标准。目前尚缺乏对开放根治性手术、腹腔镜根治性手术以及机器人辅助根治性手术的比较。本文将就以上术式进行综述。

Upper tract urothelial carcinomas include malignant tumor of renal pelvis and malignant tumor of ureter.The standard operation is open radical nephroureterectomy.With the development of laparoscopic technology, more and more urologists are applying laparoscopic technique to the treatment of upper tract urothelial carcinomas.Although laparoscopic surgery has obvious advantages over open surgery, it is difficult to operate.The application of robot-assisted laparoscopic techniques overcomes many of the limitations of complex laparoscopic techniques.Thus, it provides more choices for clinicians.In addition to intraoperative bleeding and surgical injury and length of hospital stay, the risk of recurrence of bladder tumor is also an important criterion to determine the feasibility of an operation.There is currently no comparison of open radical surgery, laparoscopic radical surgery and robot-assisted radical surgery.This article will review the above techniques.