晚期肿瘤致输尿管梗阻支架置入困难的微创处理  

Minimally invasive management for ureteric obstruction caused by malignant disease in patients failed in retrograde ureteral stent placement

作　　者：邓旺龙[1] 陈善群[1] 许良余[1] 徐清伟[1] 李志红[2] 

机构地区：[1]郴州市第一人民医院泌尿外科一区,湖南郴州423000 [2]郴州市第一人民医院普外科,湖南郴州423000

出　　处：《现代肿瘤医学》2015年第14期2010-2012,共3页Journal of Modern Oncology

基　　金：湖南省科技厅项目(编号:2013FJ3061)

摘　　要：目的:对微创手术技术处理恶性肿瘤致输尿管梗阻输尿管支架置入困难病人,探讨其手术方法、技巧等临床处理经验。方法:回顾性分析14例(19侧)恶性肿瘤继发输尿管梗阻输尿管支架置入困难的病人分别通过逆行输尿管扩张置管术、经皮肾穿刺顺行斑马导丝引导下置管术、微创经皮肾造瘘术解除梗阻,分析临床处理过程及治疗效果。结果:所有14例患者通过三种手术方式成功解除梗阻,随访所有患者肾功能在术后短期内恢复正常水平并顺利完成后续治疗,手术过程顺利,无重大并发症发生。结论:微创逆行输尿管扩张置管术、经皮肾穿刺顺行斑马导丝引导置管术和经皮肾穿刺造瘘术可以解决晚期肿瘤肾后性梗阻置管困难问题,是安全有效的手术方式。Objective：To analyze the clinical experience and skills in invasive treatment of the patients with ureteric obstruction caused by malignant disease but failed in ureteral stent placement.Methods：We retrospectively analysed 14 patients （19 cases） with malignant ureteral obstruction but difficult to indwell retrograde ureteral stent in recent 5 years,using retrograde ureteral stenting through ureter dilation,percutaneous puncture antegrade ureteral stenting or percutaneous nephrostomy.Results：All the ureteric obstruction of the 14 patients were successfully relieved by minimal invasively treatment through the three precedures.The renal function of the patients gradually returned to normal and further treatment was done.No procedure related complications occured.Conclusion：Minimally invasive procedures such as retrograde ureteral stenting through ureter dilation,percutaneous puncture antegrade ureteral stenting,and percutaneous nephrostomy are safe and effective to treat malignant ureteric obstruction which were dificult to indwel retrograde ureteral stent.

关 键 词：恶性肿瘤 输尿管梗阻 微创手术 

分 类 号：R730[医药卫生—肿瘤]