经输尿管镜钬激光治疗原发性输尿管息肉  

Efficacy of ureteroscopic holmium： YAG laser for primary ureteral polyp

作　　者：何鹏[1] 邹建华[1] 罗一钊[1] 冯强[1] 熊国兵[1] 邱明星[1] 黄翔[1] He Peng;Zou Jianhua;Luo Yizhao(Department of Urology,Sichuan Academy of Medical Sciences ＆Sichuan Provincial People＇s Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院,四川省人民医院泌尿外科,四川成都610072

出　　处：《国际泌尿系统杂志》2018年第4期595-597,共3页International Journal of Urology and Nephrology

摘　　要：目的 探讨经输尿管镜钬激光治疗原发性输尿管息肉的可靠性与疗效.方法 选取2013年4月至2015年4月在本科室采用输尿管镜下钬激光切除术治疗输尿管息肉患者6例.其中男1例、女5例,年龄22～35岁.息肉位于左侧输尿管患者2例,右侧输尿管患者4例.患者主要症状为患侧腰腹部疼痛.影像学检查显示患侧肾有不同程度的积水,患侧输尿管存在充盈缺损和狭窄.通过硬膜外麻醉,调整钬激光功率40 W,于息肉基底部沿输尿管正常黏膜水平切除息肉,患侧输尿管内常规留置F5双J管,术后4～6周经膀胱镜拔除,切除的息肉标本以输尿管异物钳取出,送病理检查.结果 本组5例手术顺利,无输尿管穿孔、撕脱等并发症发生,手术时间30～ 60 min,术中出血极少,手术视野清晰;另一例因息肉段长,采用二期手术治愈.术后病理检查报告均为输尿管纤维上皮性息肉.术后随访2～6个月,患者症状完全消失,患侧肾积水均有明显改善.结论 经输尿管镜钬激光治疗原发性输尿管息肉的方法可靠,疗效较好.Objective To investigate the efficacy of ureteroscopic holmium：YAG laser in the treatment of primary ureteral polyp.Methods The records of patients undergoing ureteroscopic holmium：YAG laser therapy for primary ureteral polyp at our institution from April 2013 to April 2015 were retrospectively reviewed.A total of six available patients were included for analysis,one was male and the other five were females,the range of patient ages were from 22 to 35 years.Two cases were left primary ureteral polyps and the other four cases were right.The main symptoms of patients were waist and abdomen pain in the affected sides.Epidural anesthesia was applied,laser power was adjusted to 40 W and isotonic saline continuous irrigation,the ureteral polyps were resected along the normal mucosa at the ureter basement following by bleeding and trimming wound.At last,Fr5 double-J stents were implanted routinely.These ureter stents were removed after four to six weeks.The resection specimens of ureteral polyp were removed by foreign body forceps for further histopathologic examination.Results The operations of five cases succeeded and no complications such as ureteral avulsion or perforation occurred.The operation time was 30 to 60 minutes,the blood loss of operation were very low,operational views were quite clear.The another case was cured by two-stage operation as polyp was too long.The postoperative pathological examination reports of all cases were fibroepithelial polyp.Through 2-6 months＇ following up,the patients＇ symptoms disappear completely,and hydronephrosis was improved.Conclusions The ureteroscopic holmium：YAG laser will be safe and effective in the treatment of primary ureteral polyp.

关 键 词：输尿管肿瘤 息肉 输尿管镜 激光 固体 钬 

分 类 号：R737.13[医药卫生—肿瘤]