后腹腔镜联合经尿道输尿管口电切术治疗肾盂输尿管肿瘤(附17例报告)  

Retroperitoneal laparoscopic radical nephroureterectomy with transurethral bladder-cuff excision for renal pelvic and ureteral tumors: with a report of 17 cases

作　　者：沈军[1] 郭国响[1] 叶琪辉[1] 谢磊[1] 杨伟峰[1] 崔建军[1] 汤珺[1] 夏宏辉[1] 

机构地区：[1]广东医学院附属南山医院,广东深圳518052

出　　处：《腹腔镜外科杂志》2013年第7期489-491,共3页Journal of Laparoscopic Surgery

摘　　要：目的:评估后腹腔镜联合经尿道输尿管口电切术治疗肾盂、输尿管肿瘤的临床疗效。方法:2008年10月至2013年1月为17例肾盂或输尿管移行细胞癌患者行后腹腔镜根治性肾输尿管切除术,其中肾盂癌11例,输尿管癌6例。经尿道袖状电切患侧输尿管口周围1 cm范围膀胱壁,采用后腹腔镜切除肾及全长输尿管,完整取出切除的肾输尿管。术后常规吡柔比星膀胱灌注。结果:手术时间平均(186.9±30.2)min;术中出血量平均(110.1±38.6)ml;术中、术后未发生明显并发症。术后随访3～51个月,1例发生膀胱移行细胞癌。结论:后腹腔镜联合经尿道电切镜治疗肾盂癌、输尿管癌具有手术损伤小、康复快等优点,且不增加肿瘤种植风险,临床应用前景良好。Objective：To evaluate the therapeutic effect of retroperitoneal laparoscopic radical nephroureterectomy with tran- surethral bladder-cuff excision for renal pelvic and ureteral tumors. Methods：Between Oct. 2008 and Jan. 2013, retroperitoneal laparo- scopic radical nephroureterectomy with transurethral bladder-cuff excision was performed in 17 patients, including 11 cases of renal pel- vic and 6 cases of ureteral transitional cell carcinoma. The bladder wall within 1.0 cm around affected ureteral orifice was electronically excised, retroperitoneal laparoscopic nephroureterectomy was performed. The entire kidney and ureter specimens were removed. Routine THP bladder irrigation was performed in all cases. Results：In this study, the mean operative time was （186.9 ~ 30.2 ） rain, the mean blood loss was （ 110.1 ＋ 38.6 ） ml, and no intraoperative and postoperative complications occurred. During a follow-up of 3-51 months, 1 case was found suffering from bladder transitional cell carcinoma. Conclusions：Retroperitoneal laparoscopic radical nephroureterecto- my with transurethral bladder-cuff excision for renal pelvic and ureteral carcinoma has the advantages of minimal invasion and rapid re- covery, and dose not increase the risk of tumor implantation. It can partly take place of conventional open surgery and has a good pros- pect in the urologic clinical practice.

关 键 词：肾肿瘤 输尿管肿瘤 肾输尿管切除术 腹腔镜检查 腹膜后路径 

分 类 号：R737.1[医药卫生—肿瘤]