[1]陈显成 甘卫东 刘铁石 徐林锋 屈峰 燕翔 郭宏骞.选择性应用保留肾脏术式治疗原发性输尿管癌[J].中华腔镜泌尿外科杂志(电子版),2014,(03):167-170.
 Chen Xiancheng,Gan Weidong,Liu Tieshi,et al.Preliminary experience of nephron-sparing surgery for selective patients with primary ureteral carcinoma[J].,2014,(03):167-170.
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选择性应用保留肾脏术式治疗原发性输尿管癌()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2014年03期
页码:
167-170
栏目:
临床研究
出版日期:
2014-06-30

文章信息/Info

Title:
Preliminary experience of nephron-sparing surgery for selective patients with primary ureteral carcinoma
作者:
陈显成 甘卫东 刘铁石 徐林锋 屈峰 燕翔 郭宏骞
210008南京,南京大学医学院附属鼓楼医院泌尿外科
Author(s):
Chen Xiancheng Gan Weidong Liu Tieshi Xu Linfeng Qu Feng Yan Xiang Guo Hongqian.
Department of Urology, Drum Tower Hospital Affiliated to Medical College of Nanjing University, Jiangsu Province, Nanjing 210008, China
关键词:
输尿管肿瘤保留肾脏手术输尿管部分切除术
摘要:
目的 探讨在输尿管癌患者中选择性应用保留肾脏术式的可行性及其疗效。方法 回顾性分析我院 2004年 5月至 2012年 5月应用保留肾脏术式治疗原发性输尿管癌 13例患者资料,其中男性 7例,女性 6例,年龄 43~76岁,平均 63.4岁。病变位于左侧 5例,右侧 7例,双侧 1例。肿瘤位于输尿管中段 1例,下段 12例。所有患者均经手术治疗,术后随访通过患者定期门诊复查及电话随访完成。结果 13例患者中行输尿管肿瘤切除 +输尿管端端吻合术 4例,输尿管末端及膀胱袖套状切除 +输尿管膀胱再植术 8例, 1例双侧输尿管癌患者行左侧输尿管肿瘤切除 +输尿管端端吻合和右侧输尿管末端及膀胱袖套状切除 +右侧输尿管膀胱再植术。所有手术均未出现尿漏、出血等严重的并发症。肿瘤标本最大直径为 0.6~1.9 cm,平均 1.7 cm,病理均提示为尿路上皮癌,其中 T1G1期 6例, T2G1期 2例, T1G2期 2例, T2G2期 1例, T1G3期 2例。术后 13例患者随访时间 1~6年,平均随访时间 3.5年。双侧输尿管癌患者术后 9个月复查输尿管镜时发现左侧输尿管端端吻合处肿瘤复发,术中使用钬激光烧灼肿瘤,目前密切随访中;1例高级别尿路上皮癌患者死于肿瘤全身多发性转移;1例患者死于脑梗塞;其余患者目前均无复发征象。结论 对于肿瘤分期和分级较低、体积较小和位于输尿管中下段的输尿管癌患者,保留肾脏术式是可以选择的手术方式,特别适合不能耐受较大手术、慢性肾功能不全、孤立肾或双侧输尿管癌患者。

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:江苏省自然科学基金面上项目( BK20131281)
通讯作者:甘卫东,Email:gwd@nju.edu.cn
更新日期/Last Update: 2014-06-25