Boari膀胱肌瓣在中下段输尿管癌中的应用（附8例报告）.docVIP

Boari膀胱肌瓣在中下段输尿管癌中的应用（附8例报告） 苑海波 王强 殷晓松 周磊 韩刚 刘同伟 [摘要] 目的 观察Boari膀胱肌瓣在保留肾脏治疗中下段输尿管癌的临床效果。方法 回顾性分析252医院2011年8月至2014年5月采用Boari膀胱肌瓣治疗8例中下段输尿管癌患者的临床资料，其中男性4例，女性4例，其中孤立肾4例，对侧肾因外伤后致肾萎缩1侧，输尿管结石致肾重度积水1侧，肾结石伴肾轻度积水1侧，肾错构瘤1侧。年龄45-72岁，平均58.7岁，病变位于左侧5例，右侧3例，肿瘤位中段5例，下段3保定市第二五二医院泌尿外科 071100 TELEmail：yuanhbo6@例。术前6例合并肾功能不全，肌酐168-302umol/L，平均207.4 umol/L。收集肿瘤大小、病理分级、分期、肾功能水平等数据，观察患者术后肾积水、肾功能恢复及肿瘤复发情况。结果 8例患者均顺利完成手术，5例行开放手术，3例采用腹腔镜手术，输尿管肌瓣长度3-10cm，平均5.8cm。所有手术均未出现尿漏、出血、腹腔脏器损伤等并发症，输尿管支架管留置2月后拔除。肿瘤标本直径为2.5-3.2cm，平均2.8cm，病理结果均提示尿路上皮癌，其中T1G1期4例，T2G1期2例，T1G2期2例。术后随访时间8-40月，平均随访26月，未出现肾积水、肾功能受损 保定市第二五二医院泌尿外科 071100 TELEmail：yuanhbo6@ 【关键词】 Boari膀胱肌瓣；中下段输尿管癌；保留肾脏手术 Clinical application of Boari bladder flap plasty surgery for the treatment of middle and lower ureteral carcinoma(Report of 8 cases) 【Abstract】 Objective To observe the clinical effect and outcome of Boari bladder flap plasty surgery for the treatment of nephron-sparing strategy for patients with middle and lower ureteral carcinoma.Methods From August 2011to May 2014,8cases of middle and lower ureteral carcinoma who undergone Boari bladder flap plasty surgery in our hospital were re-viewed retrospectively.With an average age of 58.7 years(range from 45 to 72),4 cases were male and 4 cases female.Including?solitary kidney（4 cases）,?contralateral renal atrophy induced by renal?injury（1 case）,?ureteral calculi?induced renal?severe?hydronephrosis?(1 case),?renal?stones with?mild hydronephrosis?(1 case),??renal?hamartoma(1 case).5cases were located in the left ureter,3 cases were located in the right.Among the all,6cases got tumor in the middle ureter and 2cases in the distal ureter.Tumor size,stage,grade,renal function et al were collected.Observe uronephrosis,renal function recoveing and tumor reoccurred.All patients underwent the operation successfully,5 cases underwent open operation,3cases underwent laparoscopic surgery. Boari bladder flap plasty length3-10cm(average 5.8cm).Complications such as hemorr