保留肾脏手术治疗原发性输尿管癌临床疗效分析

发布时间：2018-06-18 09:28

本文选题：输尿管癌 + 输尿管切除　；参考：《中国现代医学杂志》2016年12期

【摘要】：目的探讨原发性输尿管癌保留肾脏手术的临床疗效。方法回顾性分析承德医学院附属医院1988年1月-2014年12月对原发性输尿管癌43例做了保留肾脏的手术治疗。其中,男性24例,女性19例;年龄42~84岁,平均67.3岁。肿瘤发生在左输尿管20侧,右输尿管16侧,双侧输尿管同时发生肿瘤7例。34侧肿瘤发生在远段输尿管,16侧发生在中上段输尿管。行输尿管部分切除端端吻合术16侧,行输尿管下段及膀胱袖状切除、输尿管膀胱再植30侧,4侧行输尿管镜手术。结果随访6~312个月,死亡11例,其中5例死于心脑血管疾患;4例死于其他原因,2例死于癌转移,其余32例均存活。输尿管镜手术在1年内均复发,再次切开手术。其中6例在术后6~38个月膀胱再发肿瘤,均经尿道肿瘤切除后无瘤存活。结论对低级、低期的原发性输尿管肿瘤保留肾脏手术是可行的。其预后良好,但有局部复发的危险,应密切随访。
[Abstract]:Objective to investigate the clinical effect of renal sparing surgery for primary ureteral carcinoma. Methods from January 1988 to December 2014, 43 cases of primary ureteral carcinoma were treated with kidney sparing surgery. Among them, there were 24 males and 19 females with an average age of 67.3 years (42 ~ 84 years). Tumor occurred in the left ureter (20 sides), right ureter (16 sides), bilateral ureter (7 cases) and 34 sides (16 sides of distal ureter). Partial ureterectomy and end-to-end anastomosis were performed in 16 sides, lower ureteral segment and bladder sleeve resection were performed, and ureteroscopy was performed on 30 sides and 4 sides of ureteral bladder replantation. Results during the follow-up period of 6 ~ 312 months, 11 cases died, of which 5 cases died of cardiovascular and cerebrovascular diseases, 4 cases died of other causes, 2 cases died of cancer metastasis, the other 32 cases survived. Ureteroscopy recurred within 1 year and was reopened. Among them, 6 cases had recurrence of bladder tumor 6 ~ 38 months after operation, all of them survived without tumor after transurethral resection. Conclusion Renal sparing surgery is feasible for primary ureteral neoplasms of low grade and low stage. Its prognosis is good, but has the risk of local recurrence, should be closely followed up.
【作者单位】：承德医学院附属医院泌尿外科;
【分类号】：R737.13

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