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目的:探讨保留肾脏手术治疗原发性输尿管癌的临床疗效。方法:回顾性分析我院保留肾脏手术治疗原发性输尿管癌患者14例,其中男12例,女2例,年龄54~72岁。无痛性肉眼血尿8例,腰痛5例,体检发现肾积水1例。结果:14例患者均顺利完成保留肾脏手术,输尿管部分切除、输尿管端端吻合术8例;输尿管下段切除、输尿管膀胱再植术6例。肿瘤标本直径为0.4~1.2cm。术后病理均为尿路上皮细胞癌,分级分期:T_1G_16例,T_2G_14例,T_1G_22例,T_2G_22例。所有患者均获得随访,术后6个月~2年膀胱癌发生率为14.29%(2/14),未发现输尿管癌复发者,总肾功能、分肾功能测定均正常,影像学检查均未发现肾积水或肿瘤复发。结论:保留肾脏手术方式安全可行,对治疗低分级、低分期的原发性输尿管癌疗效满意,但术前应把握手术适应证,术后需密切随访观察。
Objective: To investigate the clinical efficacy of preserving renal surgery in the treatment of primary ureteral cancer. Methods: A retrospective analysis of 14 cases of primary ureteral cancer with renal surgery in our hospital, including 12 males and 2 females, aged 54 to 72 years. Painless gross hematuria in 8 cases, 5 cases of low back pain, hydronephrosis found in 1 case. Results: All the 14 patients were successfully completed the operation of the kidney, partial ureteral resection, ureteral end-to-end anastomosis in 8 cases; lower ureter resection, ureteral bladder replantation in 6 cases. Tumor specimen diameter of 0.4 ~ 1.2cm. Postoperative pathology is urothelial carcinoma, staging: T_1G_16 cases, T_2G_14 cases, T_1G_22 cases, T_2G_22 cases. All patients were followed up. The incidence of bladder cancer was 14.29% (2/14) between 6 months and 2 years postoperatively. No recurrence of ureteral carcinoma was found. The total renal function and renal function were normal, and no imaging examination Found hydronephrosis or tumor recurrence. CONCLUSION: The preservation of renal surgery is safe and feasible. It is satisfactory for the treatment of primary ureteral carcinoma with low grade and low staging. However, surgical indication should be grasped before operation and closely followed up after operation.