全腹腔镜肾输尿管全长切除术治疗输尿管中下段尿路上皮细胞癌36例报道

发布时间：2018-02-28 20:24

本文关键词： 腹腔镜尿路上皮细胞癌输尿管肿瘤　出处：《中国现代医学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨全腹腔镜下肾输尿管全长切除及膀胱袖状切除术治疗输尿管中下段尿路上皮细胞癌的有效性及安全性。方法回顾性分析2010年9月-2016年1月采用经腹全腹腔镜下肾输尿管全长切除及膀胱袖状切除术的36例输尿管中下段尿路上皮细胞癌患者的临床资料。采用健侧45°斜卧位,先进行输尿管中下段及膀胱袖状切除术,再行肾、输尿管上段切除术。结果手术时间125(85~170)min,术中出血量90(20~250)ml,术后胃肠功能恢复时间32(18~62)h,术后平均住院时间7.8(5~11)d,无尿瘘、迟发肠穿孔、肠黏连和肠梗阻并发症发生,术后病理结果为pT_110例,pT_221例,pT_35例。随访时间超过3个月行膀胱镜的患者22例,其中发现膀胱尿路上皮细胞癌3例,行经尿道膀胱肿瘤切除术和吡柔比星膀胱灌注治疗。远处转移2例,局部复发0例。结论全腹腔镜肾输尿管全长切除及膀胱袖状切除术是治疗输尿管中下段尿路上皮细胞癌可行、安全和有效的微创手术方法。
[Abstract]:Objective to evaluate the efficacy and safety of total laparoscopic nephroureterectomy and cystectomy in the treatment of ureteral epithelial cell carcinoma in the middle and lower ureteral tract. Methods from September 2010 to January 2016, we retrospectively analyzed the efficacy and safety of total abdominal resection in the treatment of ureteral epithelial cell carcinoma. Clinical data of 36 patients with ureteral epithelial cell carcinoma in middle and lower ureteral tract underwent endoscopic nephrectomy and cystectomy with 45 掳oblique recumbent position. The middle and lower ureteral and bladder cuff resection was performed first, then nephrectomy and upper ureteral resection were performed. Results the operative time was 125 ~ 85 ~ 170 min, the intraoperative bleeding was 90 ~ 20 ~ 250 ml, the postoperative recovery time of gastrointestinal function was 3218 ~ 62h. the average hospitalization time was 7.8mm / 511d, anuria fistula, delayed intestinal perforation. The complications of intestinal adhesion and intestinal obstruction were found in 35 cases of pT_110. 22 cases were followed up for more than 3 months, and 3 cases of bladder epithelial cell carcinoma were found. Transurethral resection of bladder neoplasms and intravesical instillation of pirarubicin. Conclusion Total laparoscopic nephrectomy and cystectomy are feasible, safe and effective minimally invasive methods for the treatment of ureteral epithelial cell carcinoma in the middle and lower ureter.
【作者单位】：广州医科大学附属肿瘤医院泌尿外科;广东省东莞市第三人民医院泌尿外科;暨南大学附属第一医院泌尿外科;
【分类号】：R737.1

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