经皮肾镜取石术漏诊肾盂鳞状细胞癌的原因及诊断对策  

The causes and diagnostic strategies for missed diagnosis of renal pelvic squamous cell carcinoma in percutaneous nephrolithotomy procedures

作　　者：任胜强[1] 刘星明[1] 梁宇[1] 沈乾[1] 桑乾宏[1] 徐立奇[1] 王强辉[1] 邬旭明[1] 蔡雅富[1] 

机构地区：[1]南京军区腔内泌尿外科中心浙江宁波解放军第113医院泌尿外科,315040

出　　处：《中华腔镜泌尿外科杂志（电子版）》2011年第5期35-37,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨经皮肾镜取石术(PCNL)漏诊肾盂鳞状细胞癌的原因及诊断对策。方法自2000年2月至2009年12月采用经皮肾镜取石术(PCNL)治疗上尿路结石1250例,其中2例术后病情反复不愈,最终诊断为肾结石并肾盂鳞状细胞癌,本文回顾性分析2例肾结石并肾盂鳞状细胞癌患者诊治的临床资料。结果 2例患者均有结石病史长,伴感染、积水及顽固性疼痛等临床表现,PCNL术后1个月经改开放手术病理诊断为肾结石并肾盂鳞状细胞癌。结论微创PCNL手术时不能忽视肾结石并发肿瘤的可能性,重视临床症状及术中病理,是防止出现漏诊误诊的关键。Objective To evaluate the causes and diagnostic strategies for squamous cell carcinoma of renal pelvis missed diagnosed in percutaneous nephrolithotomy （PCNL） procedures. Methods From Feb 2000 to Dec 2009, 1250 PCNL procedures were performed to treat upper urinary stones, two of which were final diagnosed as squamous cell carcinoma for the refractory symptoms. The clinical characteristics of these two cases were retrospectively analysed. Results These two cases all had long history of kidney stones, and accompanied with infection, hydronephrosis and obstinate pain. Pathological diagnoses of squamous cell carcinoma were made when open surgeries were chosen one month after PCNL procedures. Conclusions Squamous cell carcinoma of renal pelvis should not be ignored before PCNL, especially in the patients with long history of kidney stones, hydronephrosis, infection and obstinate symptoms. The clinical symptoms and intraoperative pathological examination were critical factors to avoid missed diagnosis of malignant tumors during PCNL procedures.

关 键 词：经皮肾镜 肾结石 肾盂鳞状细胞癌 

分 类 号：R737.11[医药卫生—肿瘤]