经尿道电切镜辅助后腹腔镜治疗上尿路尿路上皮癌:附视频  

Transurethral resection-assisted retroperitoneal laparoscopic nephroureterectomy in the upper tract urothelial carcinoma

作　　者：徐林锋[1] 甘卫东[1] 张士伟[1] 李笑弓[1] 郭宏骞[1] 

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科,南京210008

出　　处：《中华腔镜泌尿外科杂志（电子版）》2015年第1期22-24,共3页Chinese Journal of Endourology(Electronic Edition)

基　　金：江苏省自然科学基金面上项目(BK20131281)

摘　　要：目的探讨经尿道电切镜辅助后腹腔镜在上尿路尿路上皮癌治疗中的应用。方法采用经尿道电切镜辅助后腹腔镜,对27例肾盂癌和10例输尿管癌患者行肾、输尿管、膀胱袖套状切除术,观察其围手术期指标(手术时间、术中失血量、术后住院时间等)和术后膀胱癌发生情况。结果 37例手术均获得成功,手术时间(146±20)min,术中失血(170±58)ml,导尿管拔除时间(7.8±0.7)d,术后住院时间(8.0±0.6)d。术中及术后无明显并发症发生。术后随访(27±10)个月,2例失访,5例(5/35)术后发生膀胱癌,5例均行经尿道电切术切除肿瘤,无膀胱外盆腔局部复发;1例(1/35)因肿瘤全身转移死亡。肾盂癌组与输尿管癌组术后结果均无统计学差异(P>0.05)。结论经尿道电切镜辅助后腹腔镜治疗上尿路尿路上皮癌具有损伤小、恢复快、对腹腔干扰少的特点,是一种微创、安全有效的治疗方法。Objective To investigate the application of transurethral resection-assisted retroperitoneal laparoscopic nephroureterectomy in the upper tract urothelial carcinoma. Methods A total of 37 patients, 27 with carcinoma of renal pelvis and 10 with ureteral carcinoma, underwent transurethral resection of the bladder cuff and retroperitoneal laparoscopic nephroureterectomy. The operation time, blood loss, postoperative hospital stay and tumor recurrence rate were observed. Results The transurethral resection- assisted retroperitoneal laparoscopic nephroureterectomy was performed successfully in all cases. No serious complication happened. The mean postoperative hospitalization was 8 days. During mean 27 months follow-up, bladder cancer was found in 5 cases （5/35）, no pelvic recurrence was noted out of the bladder and 1 case （1/35） died of tumor metastasis. There was no statistical difference of operation time, blood loss, postoperative hospital stay and tumor recurrence rate between the treatment of renal pelvic carcinoma and that of upper ureteral carcinoma （all P〉0.05）. Conclusion Transurethral resection-assisted retroperitoneal laparoscopic nephroureterectomy is a safe and effective treatment method and possess an advantage of minimalin vasion, and fast recovery.

关 键 词：肾盂癌 输尿管癌 后腹腔镜 经尿道切除 

分 类 号：R737.1[医药卫生—肿瘤]