腹腔镜与输尿管镜双镜联合保肾手术治疗双侧输尿管癌1例报告

65岁老年患者，肉眼血尿1月余，当地医院输尿管镜检，术中见左侧输尿管口一0.5cm菜花样新生物，取活检。右侧距输尿管口7cm见菜花样新生物，取活检。CTU:右侧输尿管下段占位伴肾积水，右侧输尿管下段小结石。病理：双侧输尿管低级别乳头状尿路上皮癌。于我院行输尿管镜检辅助定位下腹腔镜下左侧输尿管下段肿瘤切除膀胱再植术+右侧输尿管膀胱肌瓣成形术。术后病理：（左侧输尿管）低级别非浸润性尿路上皮癌，部分呈乳头状，部分上皮脱落，两端切缘（-），（右侧输尿管）高级别乳头状尿路上皮癌，局部微浸润，浸润粘膜固有层，两端切缘（-）。

Combined laparoscopic and ureteroscopic nephron-sparing surgery for bilateral ureteral carcinoma: a case report

The 65-year-old male visited the clinic of urology with gross hematuria for one month. The CT urography showed occupying lesion in right ureter, small right ureteral calculi and hydronephrosis in the right kidney. One week ago, the patient underwent cystoscopy and bilateral ureteroscopy and there was a tumor in left ureter and a tumor in right ureter. The pathologic features of biopsy showed papillary urothelial carcinoma on bilateral ureters, with high grade in right ureter lesion. Owing to low location of both lesions, we conducted laparoscopic left distal ureter tumor resection with the positioning of ureteroscopy, and left ureter bladder replantation, and laparoscopic right distal ureter tumor resection and uretero-bladder myoplasty. The pathologic features showed complete resection of tumor with negative margin, the left ureter low grade non-invasive urothelial carcinoma, the right ureter high grade papillary urothelial carcinoma with micro infiltration of mucosa lamina propria.