斜仰卧一体位后腹腔镜肾输尿管全长加膀胱袖状切除术治疗24例上尿路尿路上皮癌报告  

Oblique supine one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection in the treatment of 24 cases of upper urinary tract uroepithelial carcinoma

作　　者：闫学川 赵凯[2] 张宗亮[2] 尹心宝[2] 王振林[2] 朱冠群[2] 张玉莲 李雪禹 杨瀚 李兆峰 王庆雷 蒋在庆 王科[2] YAN Xuechuan;ZHAO Kai;ZHANG Zongliang;YIN Xinbao;WANG Zhenlin;ZHU Guanqun;ZHANG Yulian;LI Xueyu;YANG Han;LI Zhaofeng;WANG Qinglei;JIANG Zaiqing;WANG Ke(Liaoning University of Traditional Chinese Medicine,Shenyang 110000;Department of Urology,Affiliated Hospital of Qingdao University,Qingdao 266555,China;Department of Gynecology,Affiliated Hospital of Qingdao University,Qingdao 266555,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110000 [2]青岛大学附属医院泌尿外科 [3]青岛大学附属医院妇科,山东青岛266555

出　　处：《现代泌尿外科杂志》2023年第11期976-979,共4页Journal of Modern Urology

摘　　要：目的探讨改良一体位完全后腹腔镜肾输尿管全长加膀胱袖状切除术治疗上尿路尿路上皮癌(UTUC)的有效性及安全性。方法收集2022年1月—2022年6月青岛大学附属医院泌尿外科采用斜仰卧一体位后腹腔镜肾输尿管全长加膀胱袖状切除术治疗的UTUC患者临床资料,其中男性16例,女性8例,年龄62~91岁,平均年龄73岁。肿瘤位于左侧15例,右侧9例;肾盂肿瘤10例,输尿管上段肿瘤6例,输尿管下段肿瘤8例。结果24例患者手术均成功完成,无中转开放病例;手术时间为60~100 min,平均手术时间(71.25±9.80)min;术中出血量为20~200 mL,平均术中出血量(30.03±8.13)mL;术后住院时间为4~7 d,术后平均住院时间为(5.83±1.44)d;无严重术中、术后并发症;术后规范进行膀胱灌注化疗。结论斜仰卧一体位后腹腔镜肾输尿管全切除加膀胱袖状切除术治疗UTUC是一种有效、可行的术式,肿瘤控制效果良好,值得在临床上进一步推广。Objective To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma(UTUC).Methods A total of 24 patients treated during Jan.and Jun.2022 were involved,including 16 males and 8 females,aged 62 to 90(average 73)years.The UTUC was in the left side in 15 cases,and in the right side in 9 cases.There were 10 cases of renal pelvis tumor,6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor.Results All operations were successful without conversion to open surgery.The operation time ranged from 60 to 100 minutes,average(71.25±9.80)minutes.The intraoperative bleeding volume was 20 to 200 mL,average(30.03±8.13)mL.No significant intraoperative or postoperative complications occurred.The postoperative hospital stay was 4 to 7 days,average(5.83±1.44)days.Bladder perfusion chemotherapy was performed after surgery.Conclusion The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control,which is worth further promotion in clinical practice.

关 键 词：斜仰卧 一体位 后腹腔镜 上尿路尿路上皮癌 输尿管全长切除 膀胱袖状切除 

分 类 号：R615[医药卫生—外科学]