| 结直肠癌合并泌尿系统疾病的临床分析 |
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| 引用本文： | 李鹏昊,郝敬鹏,王晖,张洪团,张昌文,张志宏.结直肠癌合并泌尿系统疾病的临床分析[J].天津医科大学学报,2020,0(6):553-556. |
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| 作者姓名： | 李鹏昊 郝敬鹏 王晖 张洪团 张昌文 张志宏 |
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| 作者单位： | 1.天津医科大学第二医院肛肠外科，天津300211；2.天津医科大学第二医院泌尿外科，天津300211 |
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| 摘 要： | 目的:探讨结直肠癌累及泌尿系统或合并泌尿系统多原发癌的临床特点、诊断和治疗方法。方法:对2010-2019年我院收治的75例结直肠癌累及泌尿系统或合并泌尿系统多原发癌患者的临床病理资料进行回顾性分析。结果:16例结直肠癌累及一个或多个泌尿系统器官，其中16例全部累及膀胱，同时累及输尿管1例；59例同时或异时性合并泌尿系肿瘤，其中33例单纯合并膀胱癌，17例单纯合并前列腺癌，3例单纯合并输尿管癌，1例单纯合并肾盂癌，1例合并膀胱癌及肾癌，1例合并输尿管癌及前列腺癌，3例合并膀胱癌及输尿管癌。Dukes分期 （以病理分期最晚的一个为准）:A期0例，B期46例，C期21例，D期8例。75例中伴有淋巴结转移者29例。结直肠癌累及膀胱的16例中，结直肠癌根治联合膀胱部分切除14例，其余2例因肿瘤累及膀胱三角区行全膀胱切除及尿流改道。结直肠癌累及膀胱及输尿管的1例行膀胱部分切除、受累输尿管切除、输尿管吻合术。同时性多重癌7例，异时性多重癌52例，与原发癌间隔时间半年至 19年，其中小于2年者 15 例，2～5年者 7例，大于5年者 30 例。54例异时性多原发癌的初发癌均行根治性手术，14例二重癌和2例三重癌均行根治性切除术。同时性多原发结直肠癌和异时性多原发癌初发癌根治术后5年生存率分别为65％和70％。结论:结直肠癌合并泌尿系统疾病的患者，应利用膀胱镜、电子结肠镜及腹部强化CT进行仔细检查，避免漏诊或误诊，行根治性手术切除结直肠及泌尿系统肿瘤可能使患者生存获益。
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| 关 键 词： | 多原发癌 结直肠肿瘤 泌尿系统肿瘤 结直肠外科手术 |
Clinical analysis of colorectal cancer with urinary system diseases |
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| LI Peng-hao,HAO Jing-peng,WANG Hui,ZHANG Hong-tuan,ZHANG Chang-wen,ZHANG Zhi-hong.Clinical analysis of colorectal cancer with urinary system diseases[J].Journal of Tianjin Medical University,2020,0(6):553-556. |
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| Authors: | LI Peng-hao HAO Jing-peng WANG Hui ZHANG Hong-tuan ZHANG Chang-wen ZHANG Zhi-hong |
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| Affiliation: | 1.Department of Anorectal Surgery，The Second Hospital of Tianjin Medical University，Tianjin 300211，China；2.Department of Urology，The Second Hospital of Tianjin Medical University，Tianjin 300211，China |
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| Abstract: | Objective: To investigate the clinical features，diagnosis and treatment of colorectal cancer involving the urinary system or complicated with multiple primary cancers of the urinary system. Methods: Retrospective analysis was made on the clinicopathological data of 75 colorectal cancer patients with urinary tract involvement or multiple primary cancers of the urinary system admitted to our hospital from 2010 to 2019. Results: There were 16 cases of colorectal cancer involving one or more urinary organs，including 16 cases involving the bladder and 1 case involving the ureter. There were 59 cases of synchronous or heterochronous urinary tumors，including 33 cases with bladder cancer，17 cases with prostate cancer，3 cases with ureteral cancer，1 case with renal pelvis cancer，1 case with ureteral cancer，1 case with ureteral cancer and prostate cancer，and 3 cases with ureteral cancer and ureteral cancer. Dukes stage （according to the latest pathological stage）: 0 cases of stage A，46 cases of stage B，21 cases of stage C，8 cases of stage D. Among the 75 patients，29 had lymph node metastasis. Among the 16 cases of colorectal cancer involving bladder，radical resection combined with partial cystectomy was performed in 14 cases，and total cystectomy and urinary diversion were performed in the other 2 cases due to tumor involving trigone of bladder. Partial cystectomy，ureterectomy and ureteral anastomosis were performed in 1 case of colorectal cancer involving bladder and ureter. There were 7 cases of concurrent multiple cancers and 52 cases of heterogeneous multiple cancers，and the interval from the primary cancer was 6 months to 19 years，among which 15 cases were less than 2 years，7 cases were 2 to 5 years，and 30 cases were more than 5 years. All the 54 cases of primary heterogeneous multiple primary carcinoma underwent radical surgery，and all the 14 cases of double and 2 cases of triple carcinoma underwent radical resection. The 5 year survival rates were 65% and 70% after radical resection for synchronous multiple primary colorectal cancer and heterosynchronous multiple primary cancer，respectively. Conclusion: For patients with colorectal cancer combined with urinary system diseases，cystoscopy，electronic colonoscopy and abdominal enhanced CT should be used for careful examination to avoid missed diagnosis or misdiagnosis. Radical surgical resection of colorectal and urinary system tumors may benefit the survival of patients. |
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| Keywords: | multiple primary carcinoma colorectal cancer urinary system tumor colorectal surgery |
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