原发性输尿管癌的诊断与治疗（附13例报告）.pdfVIP

第1 3卷第1期 现 代 泌 尿 外 科 杂 志 Vo1．13 NO．1 2 0 0 8年 1月 Xiandai Miniao Waike Zazhi Jan．2008 · 论 著· 文章编号：1009—8291(2008)01—0029—03 原发性输尿管癌的诊断与治疗(附13例报告) 刘连地，黄建忠，庄东阳，黄唯庶 (福建省泉州市人民医院泌尿外科，福建泉州 362000) The diagnosis and treatment of primary ureterai carcinoma(report of 1 3 cases) Liu Liandi，Huang Jianzhong，Zhuang Dongyang，Huang Weishu (Department of Urology，the People’S Hospital of Quangzhou，Quangzhou 362000，China) ABSTRACT-Objective To improve the early diagnosis and operation treatment of primary ureteral carcinoma． Methods Thirteen cases of primary ureteral carcinoma confirmed by pathological examination were retrospectively analyzed， and the problems related to the diagnosis and treatment were discussed．Results Hematuria，flank pain and hydronephrosis were the main signs of the patients． Coloured ultrasonic scanning， CT， MRI， IVU， cystoscopy and retrograde ureteropyelography were the most important diagnostic approaches．Twelve cases were followed up for 1 0 months to 7 years． Among them，5 died of ureteral carcinoma metastasis and 7 survived．Conclusion Radical nephroureterectomy and bladder cuff resection should be the first choice of treatment for primary ureteral carcinoma，taking the belly arc·shaped slice， performing ureterectomy and bladder cuff resection，then nephrectomy up along the waist．It has the advantages of high success rate，convenience，safety，reliability，effectivity and minimal invasion． KEY WORDS：ureteral neoplasms；carcinoma；diagnosis；treatment 摘要：目的 探讨原发性输尿管癌的早期诊断及手术治疗方法，以提高治愈率。方珐 回顾性分析 13例经病理证实的原发性输 尿管癌患者的临床资料，并对诊疗问题进行讨论。结果 肉眼血尿、腰痛和肾积水是其主要临床表现，彩超、CT、MRI、IVU、膀胱 镜检及逆行输尿管插管造影是本病的基本诊断方法；12例患者获得随访，随访时间1O个月一7年，死于输尿管癌转移 5例，存活 7例。结论 患侧肾输尿管全长及膀胱袖状切除术是治疗原发性输尿管癌的首选方法，取腰腹部弧形切口先行输尿管及膀胱袖 状切除后再向上延长切口作肾切除术，具有成功率高、创伤性小、简便易行、安全可靠等优点。 关键词：输尿管肿瘤；癌；诊断；治疗 中图分类号：R737．13 文献标识码：A 原发性输尿管癌是较少见的尿路上皮恶性肿