原发性输尿管肿瘤45例临床分析  

Clinical analysis of 45 cases of primary ureteral tumor

作　　者：田思男 董伟[1] 吕家驹[1] 

机构地区：[1]山东大学附属省立医院泌尿外科,济南250021

出　　处：《临床泌尿外科杂志》2017年第8期607-609,共3页Journal of Clinical Urology

摘　　要：目的:分析原发性输尿管肿瘤患者的临床资料,进一步丰富诊疗经验。方法:对2014~2015年我科收治的45例原发性输尿管肿瘤患者的临床资料进行回顾性分析。结果:45例患者术前均行B超、CT,部分患者行膀胱镜+逆行造影、输尿管镜等检查诊断为输尿管肿瘤。45例患者全部行手术治疗,其中27例行根治手术,18例行保肾手术,术后病理证实44例为尿路上皮癌,1例为腺癌。术后随访14个月~3年,术后1年总生存率91.1%(41/45),术后2年总生存率85.0%(34/40),术后3年总生存率66.7%(14/21),其中27例行根治手术者11.1%(3/27)于术后3年内死亡;18例行保肾手术者22.2%(4/18)于术后3年内死亡。结论:联合影像学检查和内镜检查可以提高输尿管肿瘤的诊断准确率。肾及输尿管全长切除+输尿管口膀胱袖套状切除术是治疗原发性输尿管肿瘤的首选方法,其中腹腔镜手术较开放手术具有术中出血少、术后恢复快等优势。原发性输尿管肿瘤的预后与病理分级及疾病分期密切相关。Objective：To analyze the clinical data of primary ureteral tumor,and enrich the experience of diagnosis and treatment.Method：Clinical data of 45 cases of primary ureteral tumor admitted to our department from 2014 to 2015were retrospectively analyzed.Result：All the 45 patients underwent B-ultrasound and CT preoperatively,but part of the patients underwent cystoscopy＋RP or ureteroscopy before operation for the diagnosis of ureteral tumor.All the 45 patients underwent surgical treatment,of which 27 cases of radical surgery,18 cases of nephron sparing surgery.Postoperative pathology confirmed 44 cases of urothelial carcinoma,1 case of adenocarcinoma.All patients were followed up for 14 months to 3 years,and one-year,two-year and three-year overall survival rates were 91.1%（41/45）,85.0%（34/40）and 66.7%（14/21）respectively.Three patients 11.1%（3/27）who underwent radical operation died within the first three years after surgery,while four 22.2%（4/18）of the patients with nephron sparing surgery died within the first three years postoperatively.Conclusion：Combined imaging and endoscopy can improve the diagnostic accuracy of ureteral tumor.Nephro-ureterectomy and partial cystectomy is the preferred treatment method of primary ureteral tumor,and compared with open surgery,laparoscopic surgery has the advantages of less intraoperative bleeding and faster postoperative recovery,etc.The prognosis of primary ureteral tumor is closely related to pathological grade and disease stage.

关 键 词：输尿管肿瘤 诊断 治疗 预后 

分 类 号：R737.13[医药卫生—肿瘤]