Objective: To explore the characteristics of the primary ureteral carcinoma (PUC) and discuss the value of spiral CT (SCT) in the diagnosis of PUC. Methods: The SCT findings of the primary ureteral carcinoma in 16 cas...Objective: To explore the characteristics of the primary ureteral carcinoma (PUC) and discuss the value of spiral CT (SCT) in the diagnosis of PUC. Methods: The SCT findings of the primary ureteral carcinoma in 16 cases were analyzed and compared with the histopathological diagnosis and staging. Results: The transverse diameters of the lesions were 1.0–2.1 cm, and the longitudinal lengths were 1.5–15.2 cm. There were no statistically significant differences (P>0.1) in diam- eters and lengths among the low staging group (pT0–T2) and the high staging group (pT3–T4). The average CT value of the lesions was 43 HU on plain scanning, and 73 HU on CE scanning. The increment was 30 HU. The lesions were clearer on CE scanning. Curved planar reconstruction (CPR) could show the entire course of the urinary tract. Among 6 cases of pT3 stage, CT gave a correct diagnosis in 1 case. For 2 cases of pT4 stage, CT gave correct diagnoses in both cases. Conclusion: The carcinomatous lesions spread along the ureter. The longitudinal length of each lesion is longer than its transverse diameter. Tumor cannot be staged merely according to its diameter and length. CT is difficult to differentiate stage T0–T3, while for stage T4, CT diagnosis is accurate. Contrast enhancement CT scanning has the confirming and differentiating roles. CPR offers direct and easy observing images for clinical doctors.展开更多
Fifteen cases with primary ureteral carcinomas are reported with a review of the literature. We concludeL Excretory urography is the main metbod of diagnosis;retrograde uretero-pyelography is more helpful in diagnosis...Fifteen cases with primary ureteral carcinomas are reported with a review of the literature. We concludeL Excretory urography is the main metbod of diagnosis;retrograde uretero-pyelography is more helpful in diagnosis; cystoscopy is also netessary before operation;CT is useful in diagnosing and staging; ureteroscopy could be performed if necessary; the traditional total nephroureterectomy witb a cuff excision of the urinary bladder remains the basic treatment of choice; cystoscopy,excretory urography and adjuvant intravesical therapy should he carried out regularly after operation.展开更多
It is well known that one-stage resection of synchronous multiple primary colorectal carcinoma is an ideal choice if the patient＇s physical condition is not bad. Detailed examination of the whole intestinal tract is ...It is well known that one-stage resection of synchronous multiple primary colorectal carcinoma is an ideal choice if the patient＇s physical condition is not bad. Detailed examination of the whole intestinal tract is very important for patients with colorectal cancer, which could prevent patients from receiving repeat treatment to a great extent. We present a case report of a patient with synchronous primary colorectal cancer. Because pre-or intra-operative examination is not sufficient at his first consultation, the patient had undergone multiple operations after receiving chemotherapy, radiotherapy and intestinal stent insertion, which results in peritoneal adhesions formation. The preoperative placement of prophylactic ureteral catheters facilitated recognition of ureters in operation that assure the prevention of ureteral injuries. If not aware of the importance of detailed preoperative examination and standardized treatment can lead to wrong treatment as in this case. Prophylactic ureteral catheters might assist in their immediate recognition.展开更多
目的:研究针对中下段输尿管癌患者的保肾治疗策略中采用Boari膀胱肌瓣术治疗的疗效。方法:回顾性分析湘雅二医院泌尿外科从2002年7月至2007年6月采用Boari膀胱肌瓣术和输尿管癌根治术治疗中下段输尿管癌患者的临床资料及其随访情况,收...目的:研究针对中下段输尿管癌患者的保肾治疗策略中采用Boari膀胱肌瓣术治疗的疗效。方法:回顾性分析湘雅二医院泌尿外科从2002年7月至2007年6月采用Boari膀胱肌瓣术和输尿管癌根治术治疗中下段输尿管癌患者的临床资料及其随访情况,收集肿瘤大小、病理分级、分期、肾功能水平、住院时间等数据并结合患者生存情况进行统计学分析。结果:共有39例患者进行了手术治疗,包括Boari膀胱肌瓣术16例,输尿管癌根治术23例。中位随访时间为53个月(10~84个月),18名患者死亡,其中Boari膀胱肌瓣术组死亡6例,输尿管癌根治术组死亡12例。2组的5年无膀胱癌复发存活率分别为63%和59%(P>0.05),5年肿瘤特异性生存率分别为73.8%和73.5%(P>0.05),5年生存率分别为61%和57%(P>0.05),总体存活率分别为64.8%和58.1%(P>0.05)。2组间术前肾功能无明显差异[肌酐清除率57(32~104)mL/min vs 55(30~102)mL/min,P>0.05],术后Boari膀胱肌瓣术组肾功能优于输尿管癌根治术组[肌酐清除率55(35~102)mL/min vs 43(30~89)mL/min,P<0.05]。Cox比例风险回归模型多因素分析发现肾功能水平、肿瘤大小、病理分级和病理分期是影响肿瘤患者总生存期的独立因素(P<0.05),肿瘤越大、病理分级和分期越高,患者死亡风险越大,而术后高水平的肌酐清除率可以降低疾病的死亡风险。结论:Boari膀胱肌瓣术治疗中下段输尿管癌是可行的方式。相比输尿管癌根治术,Boari膀胱肌瓣术治疗后的生存率并无明显差别,而且能保护患者肾功能。展开更多
文摘Objective: To explore the characteristics of the primary ureteral carcinoma (PUC) and discuss the value of spiral CT (SCT) in the diagnosis of PUC. Methods: The SCT findings of the primary ureteral carcinoma in 16 cases were analyzed and compared with the histopathological diagnosis and staging. Results: The transverse diameters of the lesions were 1.0–2.1 cm, and the longitudinal lengths were 1.5–15.2 cm. There were no statistically significant differences (P>0.1) in diam- eters and lengths among the low staging group (pT0–T2) and the high staging group (pT3–T4). The average CT value of the lesions was 43 HU on plain scanning, and 73 HU on CE scanning. The increment was 30 HU. The lesions were clearer on CE scanning. Curved planar reconstruction (CPR) could show the entire course of the urinary tract. Among 6 cases of pT3 stage, CT gave a correct diagnosis in 1 case. For 2 cases of pT4 stage, CT gave correct diagnoses in both cases. Conclusion: The carcinomatous lesions spread along the ureter. The longitudinal length of each lesion is longer than its transverse diameter. Tumor cannot be staged merely according to its diameter and length. CT is difficult to differentiate stage T0–T3, while for stage T4, CT diagnosis is accurate. Contrast enhancement CT scanning has the confirming and differentiating roles. CPR offers direct and easy observing images for clinical doctors.
文摘Fifteen cases with primary ureteral carcinomas are reported with a review of the literature. We concludeL Excretory urography is the main metbod of diagnosis;retrograde uretero-pyelography is more helpful in diagnosis; cystoscopy is also netessary before operation;CT is useful in diagnosing and staging; ureteroscopy could be performed if necessary; the traditional total nephroureterectomy witb a cuff excision of the urinary bladder remains the basic treatment of choice; cystoscopy,excretory urography and adjuvant intravesical therapy should he carried out regularly after operation.
文摘It is well known that one-stage resection of synchronous multiple primary colorectal carcinoma is an ideal choice if the patient＇s physical condition is not bad. Detailed examination of the whole intestinal tract is very important for patients with colorectal cancer, which could prevent patients from receiving repeat treatment to a great extent. We present a case report of a patient with synchronous primary colorectal cancer. Because pre-or intra-operative examination is not sufficient at his first consultation, the patient had undergone multiple operations after receiving chemotherapy, radiotherapy and intestinal stent insertion, which results in peritoneal adhesions formation. The preoperative placement of prophylactic ureteral catheters facilitated recognition of ureters in operation that assure the prevention of ureteral injuries. If not aware of the importance of detailed preoperative examination and standardized treatment can lead to wrong treatment as in this case. Prophylactic ureteral catheters might assist in their immediate recognition.
文摘目的:研究针对中下段输尿管癌患者的保肾治疗策略中采用Boari膀胱肌瓣术治疗的疗效。方法:回顾性分析湘雅二医院泌尿外科从2002年7月至2007年6月采用Boari膀胱肌瓣术和输尿管癌根治术治疗中下段输尿管癌患者的临床资料及其随访情况,收集肿瘤大小、病理分级、分期、肾功能水平、住院时间等数据并结合患者生存情况进行统计学分析。结果:共有39例患者进行了手术治疗,包括Boari膀胱肌瓣术16例,输尿管癌根治术23例。中位随访时间为53个月(10~84个月),18名患者死亡,其中Boari膀胱肌瓣术组死亡6例,输尿管癌根治术组死亡12例。2组的5年无膀胱癌复发存活率分别为63%和59%(P>0.05),5年肿瘤特异性生存率分别为73.8%和73.5%(P>0.05),5年生存率分别为61%和57%(P>0.05),总体存活率分别为64.8%和58.1%(P>0.05)。2组间术前肾功能无明显差异[肌酐清除率57(32~104)mL/min vs 55(30~102)mL/min,P>0.05],术后Boari膀胱肌瓣术组肾功能优于输尿管癌根治术组[肌酐清除率55(35~102)mL/min vs 43(30~89)mL/min,P<0.05]。Cox比例风险回归模型多因素分析发现肾功能水平、肿瘤大小、病理分级和病理分期是影响肿瘤患者总生存期的独立因素(P<0.05),肿瘤越大、病理分级和分期越高,患者死亡风险越大,而术后高水平的肌酐清除率可以降低疾病的死亡风险。结论:Boari膀胱肌瓣术治疗中下段输尿管癌是可行的方式。相比输尿管癌根治术,Boari膀胱肌瓣术治疗后的生存率并无明显差别,而且能保护患者肾功能。
