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肾盂、输尿管恶性肿瘤具有多中心性、易复发等特点,手术为其主要治疗方法。腹腔镜及激光手术系统的不断进展,使其在泌尿外科得以推广应用。本研究报告了肾盂、输尿管移行细胞癌肾输尿管全程切除术后膀胱复发6例治疗情况。所有病例入院后均行膀胱镜检查、肿瘤活检及CT检查,给予绿激光膀胱肿瘤汽化切除术,术后行规律膀胱灌注吡柔比星1年,并定期复查膀胱镜、胸部X线及腹部超声等。随访5个月~6年,除1例术后18个月复发,拒绝行膀胱全切术,给予再次经尿道膀胱镜绿激光膀胱肿瘤汽化切除术外,其余5例均未见肿瘤复发及转移,未出现明显尿道狭窄及尿失禁。对于肾盂、输尿管移行细胞癌肾输尿管全程切除术后患者,应警惕其膀胱复发可能。为降低膀胱复发率,术后应给予规律膀胱灌注,定期行膀胱镜检查,必要时行泌尿系CT或MRI检查,以免延误病情,并争取保留患者膀胱,尽量采用膀胱镜下微创治疗。
Renal pelvis, ureteral malignancies with multi-center, easy to relapse, etc., surgery as its main treatment. Laparoscopic and laser surgery system continues to progress, so that it can promote the use of urology. This study reported the renal pelvis, ureter transitional cell carcinoma of the kidney after radical resection of bladder recurrence in 6 cases of treatment. All patients underwent cystoscopy, tumor biopsy and CT examination after admission, given green laser bladder tumor vaporization resection, postoperative regular intravesical instillation of pirarubicin 1 year, and regular review cystoscopy, chest X-ray and abdominal ultrasound Wait. All the patients were followed up for 5 months to 6 years. All except one case relapsed 18 months after operation, they refused to perform total curative resection of the bladder, and given transurethral cystoscope green laser bladder tumor with vaporization resection. The other 5 cases showed no tumor recurrence and metastasis , There is no obvious urethral stricture and urinary incontinence. For the renal pelvis, ureteric transitional cell carcinoma of kidney ureter resection patients, should be wary of bladder recurrence may be. In order to reduce the recurrence rate of the bladder, regular bladder irrigation should be given after operation. Cystoscopy should be performed on a regular basis. CT or MRI of urinary system should be performed if necessary so as to avoid delay of the disease and keep the bladder of the patient. Minimally invasive treatment with cystoscopy is recommended.