原发性输尿管癌治疗体会(附36例报告)

Primary ureteral cancer (report of 36 cases)

目的 提高原发性输尿管癌的诊断与治疗水平。 方法 回顾性分析 36例经病理证实原发性输尿管癌患者的临床表现、诊断及治疗方法。男 2 2例 ,女 14例。平均年龄 6 3岁。右侧 14例 ,左侧 2 1例 ,双侧 1例。 36例 (37侧 )均手术治疗。 结果 随访 34例 (94 % ) ,随访时间 6个月～15年 ,死于输尿管癌转移和其他疾病各 6例 ,存活 2 2例。 3例输尿管部分切除术后 1～ 5年局部或膀胱再发肿瘤。 结论 患侧肾、输尿管和膀胱袖状切除仍是治疗原发性输尿管癌的金标准。下段输尿管癌 ,主张先行下段输尿管及膀胱袖状切除后再作肾切除 ,可减少或避免挤压所致癌细胞膀胱种植。

Objective To improve the diagnosis and treatment of primary ureteral cancer. Methods Thirty-six cases of primary ureteral cancer ascertained by pathological studies were reviewed.There were 22 men and 14 women with the mean age of 63 years.All patients underwent operation. Results Thirty-four cases (94%) were followed up for 6 to 180 months.Among them,6 died of metastasis,6 died of other diseases and 22 survived.Local recurrence in ureter or bladder occured in 3 patients 1～5 years after partial ureterectomy. Conclusions Nephroureterectomy and bladder cuff resection is the best treatment for primary carcinoma of ureter.Ureterectomy and bladder cuff resection should be carried out prior to nephrectomy for the lower segment ureteral carcinoma in order to lessen carcinoma cell transplantation in bladder.