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目的:探讨双侧上尿路同时发生移行细胞癌患者的诊疗措施。方法:收集了1994年7月~2014年12月收治11例双侧上尿路同时发生移行细胞癌患者的临床资料,其中男1例,女10例。均有慢性肾功能不全、无痛性肉眼血尿,并经影像学和输尿管镜等检查确诊。4例行后腹腔镜肾输尿管全长切除术,1例行开放的肾输尿管全长切除术,2例行开放的输尿管全长切除术和肾造瘘术,4例患者拒绝手术仅行保守治疗。结果:术后病理检查均为移行细胞癌。随访11~113个月,平均37个月。随访期间6例死亡,1例术后发生膀胱肿瘤。结论:双侧上尿路同时发生移行细胞癌,根据肾功能情况可选择行保肾手术或肾输尿管切除术。保肾手术后应加强监测,以利早期发现复发和治疗。
Objective: To investigate the diagnosis and treatment of patients with bilateral upper urinary tract transitional cell carcinoma. Methods: Clinical data of 11 patients with bilateral upper urinary tract concurrent transitional cell carcinoma were collected from July 1994 to December 2014, including 1 males and 10 females. Have chronic renal insufficiency, painless gross hematuria, and diagnosed by imaging and ureteroscopy. 4 cases of retroperitoneal laparoscopic radical nephroureterectomy, 1 case of open radical nephroureterectomy, 2 cases of open total ureteral resection and nephrostomy, 4 cases of patients refused surgery only conservative treatment . Results: Postoperative pathological examination were transitional cell carcinoma. Follow-up 11 to 113 months, an average of 37 months. Six patients died during follow-up, and one had bladder cancer after operation. Conclusions: Both sides of upper urinary tract occur transitional cell carcinoma at the same time. Kidney nephrectomy or nephroureterectomy can be selected according to renal function. After kidney surgery should strengthen the monitoring to facilitate the early detection of recurrence and treatment.