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后腹腔镜联合经尿道电切镜治疗上尿路移行细胞癌(附83例报告) 总被引:1,自引:1,他引:0
目的 探讨后腹腔镜联合经尿道电切镜治疗上尿路移行细胞癌的效果和安全性. 方法 2003年3月~2006年7月,我院采用后腹腔镜联合经尿道电切镜治疗83例上尿路移行细胞癌.经尿道袖状电切患侧输尿管口周围1.5 cm范围膀胱壁达膀胱外脂肪组织,采用后腹腔镜切除肾及全长输尿管.术后留置导尿管7 d.11例术后辅助放疗. 结果 83例手术均成功.手术时间115~205 min,平均156 min.术中出血50~150 ml,平均80 ml.无术中并发症.术后住院7~11 d,平均8.5 d.病理报告:82例上尿路移行细胞癌,1例肾盂上皮中~重度不典型增生.术后随访3~38个月,平均10.8月.术后12个月内行膀胱镜检查发现膀胱肿瘤6例,其中5例行经尿道膀胱肿瘤电切,1例行腹腔镜根治性膀胱全切术、左侧输尿管皮肤造口术.2例肾盂肿瘤(pT3 G3和pT2 G3)于术后3个月肝转移.2例输尿管中段肿瘤(pT3 G3和pT3 G2~3)术后6个月原位复发并肺转移.1例输尿管下段肿瘤(pT3 G3)术后6个月骨转移.失访1例.其余71例均未发现肿瘤复发、切口转移及远处转移. 结论 对于上尿路移行细胞癌,采用后腹腔镜联合经尿道电切镜行肾、输尿管全切及膀胱袖套状切除具有创伤小、安全、恢复快等优点,值得临床推广应用. 相似文献
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阴囊Paget病又称阴囊皮肤湿疹样癌,是一种极少见的阴囊皮肤恶性肿瘤,临床表现不典型,极易误诊。本院自1993年~1995年收治2例,结合文献报告如下。1病例报告[例1]75岁。10年前发现阴囊皮肤有小疮疹伴瘙痒,以后疮疹融合成片状,当时诊断为芝麻疹,应用肤轻松软膏外涂治疗,瘙痒症状好转,但病变范围逐渐扩大,表面破溃有分泌物,结痂脱落后渗液停止,数日至数月后局部症状反复出现,应用多种药物久治不愈。在本院取活组织检查证实为阴囊Paget病。入院后行病灶切除术,切缘距病灶边缘2cm,1年后阴囊局部皮肤病变复发,双侧腹股沟淋巴结均… 相似文献
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重症肺炎致急性呼吸窘迫综合征(ARDS)是肾移植术后的严重并发症,亦是肾移植患者死亡的重要原因。脑的症状重,进展快,治疗难度大,患者的预后不良。自2003年1月至2007年1月,我院共收治肾移植术后并发重症肺炎致ARDS者10例,现将我们所采取的治疗措施、治疗结果等报告如下。 相似文献
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Objective To investigate the safety for donors and the effectiveness for recipients of living-related donor (LRD) kidney transplantation from elder donors. Methods 251 cases of LRD kidney transplantation were reviewed. According to the age of LRDs, the patients were divided into 2 groups:≥55 years group (group A) and <55 years (group B). The parameters studied included serum creatinine (Cr), glomerular filtration rate (GFR), creatinine clearance (Ccr), perioperative complications, average hospital stay, and acute rejection rate of LRDs and recipients were compared. Results (1)There was no significant difference in serum Cr between groups A and B at different time points (P>0.05). (2)There was no significant difference in Ccr between two groups pre-donation (P = 0.45). But at the 10th day after the donor nephrectomy, Ccr level in group A was significant lower than in group B (P<0.01). (3)Total GFR pre-donation, remaining renal GFR, and remaining renal GFR on the day 10 after donation had no significant difference in both groups A and B (P>0.05). Remaining renal GFR on the day 10 before and after donation had no significant difference in group A (P>0.05), but on the day 10 after donation that was significantly increased in group B as compared with that pre-donation (P<0.01). (4) The serum Cr of recipients at different time points after transplantation had no significant difference between two groups (P>0.05). (5) The mean hospital stay after donation of LRDs and recipients had no significant difference between two groups. (6) The incidence of recipients" acute rejection was 6.50 % (5/77) in group A, and 5.75%(10/174) in group B within 6 months after operation (P = 0.95). Conclusion Transplantations performed from the elderly donors will yield similar results from younger donors if the eider donors are evaluated or assessed as the standards. 相似文献
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Objective To investigate the safety for donors and the effectiveness for recipients of living-related donor (LRD) kidney transplantation from elder donors. Methods 251 cases of LRD kidney transplantation were reviewed. According to the age of LRDs, the patients were divided into 2 groups:≥55 years group (group A) and <55 years (group B). The parameters studied included serum creatinine (Cr), glomerular filtration rate (GFR), creatinine clearance (Ccr), perioperative complications, average hospital stay, and acute rejection rate of LRDs and recipients were compared. Results (1)There was no significant difference in serum Cr between groups A and B at different time points (P>0.05). (2)There was no significant difference in Ccr between two groups pre-donation (P = 0.45). But at the 10th day after the donor nephrectomy, Ccr level in group A was significant lower than in group B (P<0.01). (3)Total GFR pre-donation, remaining renal GFR, and remaining renal GFR on the day 10 after donation had no significant difference in both groups A and B (P>0.05). Remaining renal GFR on the day 10 before and after donation had no significant difference in group A (P>0.05), but on the day 10 after donation that was significantly increased in group B as compared with that pre-donation (P<0.01). (4) The serum Cr of recipients at different time points after transplantation had no significant difference between two groups (P>0.05). (5) The mean hospital stay after donation of LRDs and recipients had no significant difference between two groups. (6) The incidence of recipients" acute rejection was 6.50 % (5/77) in group A, and 5.75%(10/174) in group B within 6 months after operation (P = 0.95). Conclusion Transplantations performed from the elderly donors will yield similar results from younger donors if the eider donors are evaluated or assessed as the standards. 相似文献
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腹腔镜肾上腺肿瘤切除术的评价(附206例报道) 总被引:6,自引:0,他引:6
目的探讨腹腔镜下肾上腺肿瘤切除的方法和临床应用价值。方法1999年1月~2004年10月206例患者行腹腔镜肾上腺肿瘤切除术,其中采用经腹腔途径127例和经腹膜后途径79例。结果手术时间平均为(60.26±15.27)min,术中的出血量平均为(50.12±10.45)mL。术后平均住院时间为(5.42±1.21)d。中转开放手术2例(0.98%)。发生并发症2例(0.98%),分别为膈肌损伤、皮下血肿各1例。结论腹腔镜下行肾上腺肿瘤切除术具有创伤小、术中出血少、术后恢复快等优点,在肾上腺手术中有广泛的应用前景。 相似文献