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目的 探讨肾盂输尿管癌的最佳手术方式及预防术后再发膀胱癌的有效措施。 方法 对 94例采用不同术式治疗肾盂输尿管癌患者术后再发膀胱癌的临床资料进行总结。 结果 单发肾盂或输尿管癌行肾盂输尿管切除术 (未切除壁间段输尿管及管口周围部分膀胱 )术后膀胱癌再发率为 5 4.5 % (6 /11) ,明显高于肾盂输尿管膀胱部分切除术 (2 3.5 % ,12 /5 1)和改良膀胱粘膜袖套状切除法肾盂输尿管膀胱部分切除术 (33.3% ,3/9) ,差别有显著性意义 (P <0 .0 5 ) ;后二者比较差别无显著性意义 (P >0 .0 5 )。肾盂输尿管癌术后再发时间短 ,多位于病侧管口周围。肾盂输尿管多器官癌行肾盂输尿管膀胱部分切除术后膀胱癌再发率为 72 .2 % (13/18) ,与改良膀胱粘膜袖套状切除法肾盂输尿管膀胱部分切除术 6 0 % (3/5 )比较 ,差别无显著性意义 (P >0 .0 5 )。 结论 改良膀胱粘膜袖套状切除法可防止瘤细胞种植 ,是一良好的治疗方法。彻底切除病侧管口周围部分膀胱壁是预防术后再发膀胱癌的关键。
Objective To investigate the best surgical treatment of ureteropelvic cancer and effective measures to prevent recurrent bladder cancer after operation. Methods The clinical data of 94 patients with recurrent bladder cancer undergoing different surgical procedures for the treatment of renal pelvic and ureteral cancer were summarized. Results The recurrence rate of bladder cancer after single ureteropelvic or ureteropelvicoperation (ureteropelvic excision and bladder around the orifice) was 5 4.5% (6/11), which was significantly higher than that of the ureteropelvic bladder Resection (23.5%, 12/5 1) and modified bladder mucosa cuff resection pelvic ureter partial resection (33.3%, 3/9), the difference was significant (P <0.05); There was no significant difference between the two groups (P> 0.05). The ureteropelvic cancer recurrence time is short, mostly located in the side of the iliac orifice. The recurrence rate of bladder cancer was 72.2% (13/18) after resection of ureteropelvic polyposis colorectal cancer after pelvic ureteropelvic partial ureteropectomy, and 60% (3 / 5), the difference was not significant (P> 0.05). Conclusion Modified sleeve cuff resection of bladder mucosa can prevent tumor cells from growing, which is a good treatment. Radical resection of the bladder wall around the part of the spout is the key to preventing recurrent bladder cancer.