输尿管镜在上尿路上皮癌诊治中的利与弊

Advantages and disadvantages of ureteroscope in the diagnosis and treatment of upper tract urothelial

输尿管镜技术在上尿路上皮癌(UTUC)的诊治中发挥着重要作用。传统输尿管镜检查(URS)不仅可以确定肿瘤的位置、外观和大小,还可以通过活检确定肿瘤分级。电子输尿管软镜及辅助技术的发展为UTUC的诊断带来了显著的进步。输尿管镜激光消融术可以治疗低级别恶性肿瘤、肾功能不全或孤立肾的患者。然而使用URS也有潜在的风险,如延迟根治性治疗、增加手术难度、术中或术后并发症和膀胱内复发等。本文就输尿管镜在UTUC诊治中的利与弊进行综述。

Ureteroscopy plays an important role in the diagnosis and treatment of upper tract urothelial carcinoma(UTUC).Conventional ureteroscopy(URS)can not only identify the location,appearance and size of a tumor,but also assess tumor grade by biopsy.The continued development of electronic flexible ureteroscopy and assistive technologies has led to further advances in the diagnosis of UTUC.Ureteroscopic laser ablation can be used to treat low grade malignancy,renal insufficiency,or isolated kidney.However,the use of URS may have potential risks such as delay of radical treatment,increased surgical difficulty,intraoperative or postoperative complications and intravesical recurrence.This article reviews the advantages and disadvantages of ureteroscopy in the diagnosis and treatment of UTUC.