尿路内翻性乳头状瘤151例临床分析  

Inverted urothelial papilloma:report of 151 cases

作　　者：万群[1] 罗金旦[1] 蔡松良[1] 沈柏华[1] 赵伟平[1] 张志根[1] 谢立平[1] 沈周俊[1] 

机构地区：[1]浙江大学医学院附属第一医院泌尿外科,杭州310003

出　　处：《中华外科杂志》2005年第2期105-107,共3页Chinese Journal of Surgery

摘　　要：目的探讨尿路内翻性乳头状瘤的临床表现、病理类型及临床诊治方法。方法回顾性分析1992年3月至2003年9月,我院收治尿路内翻性乳头状瘤151例,其中男134例、女17例,平均年龄54岁。临床表现主要为无痛性肉眼血尿。诊断依据泌尿系B超、尿路造影、膀胱镜检及病理检查。上尿路7例,除1例行肿瘤局部切除外余行患侧肾、输尿管全长切除术。下尿路144例,行经尿道膀胱肿瘤切除(TURBT)124例,其中11例合并良性前列腺增生者同时行经尿道前列腺切除术,前列腺部尿道肿瘤电切3例,膀胱部分切除术15例,膀胱全切术2例。结果118例随访1～125年,平均63年。5例膀胱内复发,其中2例分别于术后8,30个月发生恶变,行膀胱全切治疗。结论尿路内翻性乳头状瘤是良性肿瘤,多见于男性,好发于膀胱,TURBT是膀胱内翻性乳头状瘤的首选治疗方法。预后良好,但需定期随访。Objective To investigate the clinical features,pathology,diagnosis and treatment of inverted urothelial papilloma. Methods A total of 151 cases of urothelial inverted papilloma were analysed retrospectively. Of the cases, 134 were male and 17 were female,with a mean age of 54 years old.Most patients complained of painless gross hematuria. The diagnosis could be established mainly by ultrasonic,intravenous urography,retrograde pyelography,cystoscope and pathology. Among them,7 cases who had the papilloma at upper urinary tract underwent nephroureterectomy except one. One hundred and forty-four cases had the papilloma at low urinary tract, with 124 treated by transurethral bladder tumor resection( TURBT),among which 11 cases accompanying benign prostatic hyperplasia were treated by transurethral prostatic resection,3 by transurethral resection of prostatic urethral tumor,15 by partial cystectomy,2 by total cystectomy. Results One hundred and eighteen cases were followed up 1 year to 12.5 years (mean 6.3 years). Intravesical recurrence was found in 5 cases. Of them 2 cases developed malignance in 8 and 30 months postoperatively,and 1 case underwent total cystectomy. Conclusions^Inverted urothelial papilloma is a benign tumor, which appears male predominant. Most of the lesions are found in the bladder. TURBT is the preferred treatment choice for inverted papilloma of the bladder. Although this disease has a good prognosis, regular follow-up observations are necessary.

关 键 词：尿路内翻性乳头状瘤 TURBT 肿瘤 治疗 临床表现 泌尿系 膀胱全切术 输尿管 

分 类 号：R737.1[医药卫生—肿瘤]