双侧同时性上尿路移行细胞癌诊治研究  

Diagnosis and Treatment of Synchronous Bilateral Transitional Cell Carcinoma of the Upper Urinary Tracts

作　　者：杨绍波[1] 孔垂泽[1] 姜元军[1] 张宇曦[1] 毕建斌[1] 

机构地区：[1]中国医科大学附属第一医院泌尿外科,沈阳110001

出　　处：《临床泌尿外科杂志》2011年第11期829-830,共2页Journal of Clinical Urology

摘　　要：目的:提高双侧上尿路移行细胞癌的诊断率并探讨双侧上尿路同时发生移行细胞癌患者的治疗策略。方法:报告5例双侧上尿路同时发生移行细胞癌患者的临床资料,均有无痛性全程肉眼血尿,有2例肾功不全,4例术前行B超、IVP、CTU及逆行造影检查,2例术前获得诊断,2例一侧仅表现异常,术中获得确诊。4例均行保肾手术。1例在外院仅诊断一侧肿瘤,并行根治性切除术,20天后又在我院确诊对侧也存在肿瘤并行保肾手术。结果:随访14～40个月,平均26个月。随访期间1例死亡,2例术后发生膀胱肿瘤,2例未见肿瘤复发。结论:双侧上尿路同时发生移行细胞癌易漏诊一侧,保肾手术是治疗的最优选择。Objective： The diagnosis and treatment of the transitional cell carcinoma of synchronous bilateral upper urinary tracts were explored. Methods： The clinical data of 5 cases with transitional cell carcinoma of synchronous bilateral upper urinary tracts were reported. All of these 5 patients were with renal painless hematuria. 2 cases were with renal insufficiency. 4 cases were examined by 13 ultrasonography, IVP, CTU and retrograde ultrography. The diagnosis was confirmed in 2 cases, 2 cases were confirmed during operation, operations were done in 4 patients with reservations of the kidney. 1 case misdiagnosed as unilateral tumor in another hospital and done with nephro-ureterectomy. After twenty days of the operation, the penitent was diagnosed bilateral tumor in our hospital and done with operation of kidney reservation. Results： All the 5 cases were followed-up for 6-40 months,the average follow-up time was 18 months. In the follow-up, 1 case died of tumor Multiple organ metastasis, 2 cases generated bladder tumor after operation, 2 cases were seen without tumor recurrence. Conclusions： When diagnosis of transitional cell carcinoma of synchronous bilateral upper urinary tracts, we usually missed diagnosis as unilateral tumor. Operation with kidney reservation should be the best choice of treatment.

关 键 词：肾肿瘤 输尿管肿瘤 双侧 同时性 

分 类 号：R737.11[医药卫生—肿瘤]