后腹腔镜联合尿道电切镜治疗上尿路尿路上皮癌疗效观察  

Retroperitoneal laparoscopic combined with resectoscopic radical nephroureterectomy for upper tract urothelial carcinoma

作　　者：张杰[1] 蔡宪安[1] 蔡懿[1] 甄洪涛[1] 刘建[1] 魏森鑫[1] 陈夏[1] 

机构地区：[1]河南省郑州市中心医院泌尿外科,450007

出　　处：《中国综合临床》2010年第5期527-528,共2页Clinical Medicine of China

摘　　要：目的探讨后腹腔镜联合尿道电切手术治疗上尿路尿路上皮癌的临床疗效。方法2006年1月至2009年7月收治的15例上尿路尿路上皮癌患者，先采用尿道电切镜行患侧输尿管口膀胱黏膜袖套状切除，然后行后腹腔镜根治性肾输尿管全切术。结果15例手术均获成功，手术时间120～180min，平均150min。术中出血100～400ml，平均200ml。肠道功能恢复时间为24～48h，3～4d内可拔除引流管。导尿管留置7～10d，拔尿管时开始行表柔吡星膀胱灌注。随访1～40个月，平均10个月，均生存，1例患者腹膜后淋巴结转移。结论后腹腔镜联合尿道电切镜手术治疗上尿路尿路上皮癌，安全、有效，且创伤小、患者恢复快。Objective To explore the therapeutic effect and application value of retroperitoneal laparoseopic combined with resectoscopic radical nephroureterectomy for upper tract urothelial carcinoma. Methods From Jan. 2006 to Jul. 2009, fifteen upper tract urothelial carcinoma patients underwent excision of bladder cuff with reseetoseope at first, and then retroperitoneal laparoseopic radical nephrouretereetomy. All tumors were confirmed to be localized, stage T1 - T3. Clinical outcomes of the patients were retrospectively analyzed. Results Mean operative time was 150 （ range ： 120 - 180 ） minutes and blood loss volume was 200 （ range ： 100 - 400 ） ml. The function of intestinal canal recovered after 24 - 48 hours, the drainage tube could be removed after 3 - 4 days. Catheter was kept for 7 - 10 days. During the follow up for 1 -40 months, all the 15 patients survived with one retroperitoneal lymphatic metastasis. There were no severe complications in perioperative and postoperative period. Conclusions Retroperitoneal laparoseopic combined with reseetoscopie radical nephrouretereetomy may be a practical surgical procedure for upper tract urothelial carcinoma patients with less intraoperative blood loss and early recovery.

关 键 词：上尿路尿路上皮癌 后腹腔镜 尿道电切镜 

分 类 号：R737.1[医药卫生—肿瘤]