6种根治性肾盂、输尿管尿路上皮癌的手术方式比较研究  

Comparative study of six operations for the treatment of upper urinary tract carcinoma

作　　者：李晓刚[1] 孙抒[2] 董秀哲[1] 金铁雄[1] 

机构地区：[1]延边大学医院泌尿外科,吉林延吉133000 [2]延边大学病理科,吉林延吉133000

出　　处：《中国癌症杂志》2016年第6期546-551,共6页China Oncology

摘　　要：背景与目的:根治性肾盂输尿管癌手术方式多种多样,每种手术方式各有优缺点,选择何种手术方式进行治疗仍有争议,该研究选择了6种根治性肾盂输尿管癌的手术方式,探讨不同术式的安全性及有效性。方法:回顾性分析2002年1月—2013年10月吉林省延吉市延边大学医院收治的135例肾盂及输尿管癌患者的临床资料,比较6种手术方式的各项指标,包括手术时间、出血量、术后肠道功能恢复时间、术后再发膀胱癌概率和术后生活质量评分差异等情况。结果:A、B组均顺利完成手术,C组5例因输尿管残端未能完全拖出而更改为A组手术方式,D组2例因输尿管残端未能完全拖出而更改为A组手术方式,E组因术区黏连或术中出血,3例更改为D组手术方式,1例更改为A组手术方式,F组1例因术中出血更改为A组手术方式,各种手术方式术后生存率比较差异无统计学意义。结论:6种治疗肾盂输尿管癌的手术方式均安全有效,但各有优缺点,临床上需根据具体情况选择不同手术方式。Background and purpose： Radical nephroureterectomy can be perfnrmed in a variety of ways, and each method has its advantages and disadvantages. It still remains controversial for choosing the surgical methods. In this study, we ,hose six surgical methods and investigated the safety and efficacy of different methods in treating upper urinary tract carcinoma. Methods： We retrospectively analyzed 135 patients with upper urinary tract transitional cell carcinoma who underwenl operatinns in our hospital from Jan. 2002 to Oct. 2013, and compared the data of six different operations inclading operating time, volume of bleeding, time of bowel function recovery and incidence of bladder carcinomas. Results： The operations were successfully completed in groups A and B. Five cases in group C were transferred into group A because of failing to pull the nub of the ureter. Two cases in group D were transferred into group A because nf failing In pull the nub of the ureter. Three cases in group E were transferred into group D and 1 case was transferred into group A because of adhesion or bleeding. One case in group F was transferred into group A because of bleeding. There was no statistically significant difference in survival rates among six operations. Conclusion： Six operations are all safe and effective for the treahnent of upper urinary tract carcinomas. Each method has its advantages and disadvantages. We should chnose different methods according to particular cases.

关 键 词：肾输尿管切除术 肾盂肿瘤 输尿管肿瘤 

分 类 号：R737.6[医药卫生—肿瘤]