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目的:探讨后腹腔镜手术治疗上尿路移行细胞癌的手术方法。方法:采用后腹腔镜手术治疗上尿路移行细胞癌21例,其中肾盂癌14例,输尿管癌7例,右侧11例,左侧10例,男13例,女8例,年龄36￣72岁,平均41岁.病理分期:A期15例,B期6例。病理分级:GradeI7例,GradeII9例,GradeIII5例。结果:手术成功20例,1例因术后出血改开放手术。手术时间100-360min,平均210min。术中出血85￣320ml,平均146ml,术中均未输血。患者术后1￣3天恢复排气并进食,2天后下床活动。术后住院时间4￣12天,平均7天。术后随访1￣30个月,无肿瘤复发,丝裂霉素间断膀胱灌注。结论:后腹腔镜根治性肾输尿管切除术手术创伤小,疼痛轻,康复快,有可能成为上尿路移行细胞癌的主要手术方法。
Objective: To investigate the surgical method of retroperitoneal laparoscopic surgery for upper urinary tract transitional cell carcinoma. Methods: 21 cases of upper urinary tract transitional cell carcinoma were treated by retroperitoneal laparoscopic surgery, including 14 cases of renal pelvic cancer, 7 cases of ureteral carcinoma, 11 cases of right side, 10 cases of left side, 13 males and 8 females, aged from 36 to 72 Years old, average 41 years old.Pathological staging: A in 15 cases, B in 6 cases. Pathological grade: GradeI7 cases, GradeII9 cases, GradeIII5 cases. Results: 20 cases were successful in surgery and 1 case was changed to open surgery due to postoperative bleeding. Surgery time 100-360min, an average of 210min. Intraoperative bleeding 85 ~ 320ml, an average of 146ml, intraoperative blood transfusion. Patients recover exhaust and eat 1 to 3 days after surgery, and get out of bed after 2 days. Postoperative hospital stay 4 to 12 days, an average of 7 days. Postoperative follow-up 1 to 30 months, no tumor recurrence, intermittent intravesical instillation of mitomycin. Conclusions: Retroperitoneal laparoscopic radical nephroureterectomy has the advantages of less trauma, less pain and quick recovery, which may become the main surgical method of upper urinary tract transitional cell carcinoma.