肾移植患者单侧上尿路上皮肿瘤术后对侧尿路预防性切除的必要性  

Necessity of prophylactic contralateral nephroureterectomy in the renal transplantation patients with transitional cell carcinoma of unilateral upper urinary tract

作　　者：田野[1] 侯海军[1] 郭宇文[1] 张磊[1] 林俊[1] 朱一辰[1] 孙雯[1] 谢泽林[1] 

机构地区：[1]首都医科大学附属北京友谊医院泌尿外科,北京100050

出　　处：《北京大学学报（医学版）》2013年第4期558-561,共4页Journal of Peking University:Health Sciences

基　　金：国家重点基础研究发展计划(973计划;2009CB522401)资助~~

摘　　要：目的:探讨肾移植患者在一侧肾盂癌或输尿管癌术后,对侧上尿路预防性切除的必要性及安全性。方法:2006年12月至2013年5月对15例肾移植术后发现原肾肾盂癌和(或)输尿管癌的患者行腹腔镜下单侧上尿路切除术,术后3个月内行对侧上尿路预防性切除,术后给予常规的膀胱灌注化疗及定期随访。结果:15例患者中,患侧切除的15例肾及全长输尿管术后病理检查均证实为尿路上皮癌,而预防性切除的对侧15例中也有7例患者术后证实为尿路上皮癌,预防性切除的上尿路上皮肿瘤发生率约为46.7%(7/15)。术后平均随访36个月,存活13人,存活率86.7%。结论:肾移植术后发生一侧上尿路上皮肿瘤后,对侧上尿路发生上皮肿瘤的概率很高。在患者身体状况允许的情况下,行对侧上尿路预防性切除非常必要。Objective：To discuss the necessity of prophylactic contralateral nephroureterectomy in renal transplantation patients with upper urinary tract transitional cell carcinoma（TCC）.Methods： In our study 15 renal transplantation patients with upper urinary tract TCC were involved from Dec.2006 to May 2013.All the patients received prophylactic contralateral nephroureterectomy 3 months after their last nephroureterectomy.A retrospective analysis was performed.Results： TCC of upper urinary tract was confirmed by postoperative pathology in all the 15 cases.Similarly,TCC of contralateral upper urinary tract was detected in 7 of these cases（46.7%）,and 13 survived after 36 months’ follow-up（86.7%）.Conclusion： In the renal transplantation patient with unilateral upper urinary tract TCC,the possibility of contralateral upper urinary tract TCC is high,thus the necessity of prophylactic contratateral nephroureterectomy is certain.

关 键 词：肾移植 输尿管肿瘤 肾切除术 肾盂积水 尿道上皮 

分 类 号：R699.2[医药卫生—泌尿科学]