软性输尿管镜下绿激光治疗解剖性孤立肾肾盂肾盏尿路上皮癌4例报告并文献复习  

Transurethral flexible ureteroscopic GreenLight laser treatment of pyelocalyceal urothelial carcinomas for patients with an anatomical solitary kidney: a report of 4 cases and literature review

作　　者：潘东亮[1] 晋连超[1] 杨冰[1] 朱鹤[1] 张祥华[1] 那彦群[1] 

机构地区：[1]北京大学首钢医院吴阶平泌尿外科医学中心,北京100144

出　　处：《现代泌尿外科杂志》2013年第3期218-222,共5页Journal of Modern Urology

基　　金：中国科学院环境化学与生态毒理学国家重点实验室开放基金(No.KF2011-12)

摘　　要：目的报道4例解剖性孤立肾肾盂肾盏尿路上皮癌患者采用软性输尿管镜下绿激光治疗的过程,并结合文献对此治疗方式进行评价。方法 4例患者均为解剖性孤立肾。病例1为80岁女性,左侧肾盂及肾上盏尿路上皮癌;病例2为右肾下盏尿路上皮癌;病例3为左侧肾盂及输尿管多发癌;病例4为右侧肾盂癌。均采用软性输尿管镜下Realton PVP-100型绿激光(直射光纤,直径497μm,功率10～30W)治疗,术后通过泌尿系CT和/或输尿管镜随访。结果 4例患者手术均顺利,无并发症。病例1和病例2随访6个月无复发;病例3术后4个月时复发,自行中药治疗;病例4随访3个月无复发。结论软性输尿管镜下绿激光治疗孤立肾肾盂肾盏尿路上皮癌可行性强、安全有效、副损伤少;可作为治疗孤立肾肾盂肾盏尿路上皮癌的首选方法之一,而且可反复应用;但是由于术后复发率较高,需严密随访。Objective To report the treatment procedure of pyelocalyceal urothelial carcinomas for 4 patients with an anatomical solitary kidney using transurethral flexible ureteroscopic GreenLight laser （TUFUGL） and to evaluate its efficacy and review literature. Methods Case 1 was 80-year-old female with urothelial carcinomas of renal pelvis and upper calyx in the left solitary kidney. Case 2 was urothelial carcinomas of lower calyx in his right solitary kidney. Case 3 was multifocal carcinomas in his left renal pelvis and ureter. Case 4 was carcinomas of right renal pelvis. They all underwent TUFUGL ablation and were followed up through CT scan and/or flexible ureteroscopy. Results All four patients underwent the operations safely and no complications happened. Case 3 recurred four months postoperatively and refused any further surgical treatment and accepted Chinese herbal medicine. The other three patients showed no recurrence during three to six months of follow-up till now. Conclusions TUFUGL treatment of pyelocalyceal urothelial carcinomas for patients with an anatomical solitary kidney showed feasibility, safety and validity. It may be regarded as one of the first-choice treatments for pyelocalyceal urothelial carcinomas of an anatomical solitary kidney and could be used repeatedly. But these patients needed intensive follow-up because of the high rate of recurrence.

关 键 词：尿路上皮癌 肾盂肾盏 孤立肾 软性输尿管镜 绿激光 治疗学 

分 类 号：R737[医药卫生—肿瘤]