输尿管口附近膀胱肿瘤的手术改良处理

目的　总结探讨输尿管口附近膀胱肿瘤的手术治疗经验 ,为膀胱肿瘤手术治疗提供参考。方法　 1998年 2月至2 0 0 2年 10月收治的需行输尿管再植的膀胱肿瘤患者 3 5例 ,随机分为A、B组两组 :A组 17例 ,输尿管口附近膀胱肿瘤作标准切除至深肌层 ,输尿管残口仅作外翻处理 ;B组 18例 ,膀胱外离断输尿管 ,膀胱部分切除术后将输尿管再植于膀胱。随访 1年 ,对两组膀胱输尿管返流、输尿管梗阻、肾功能影响及肿瘤复发率进行对比分析。结果　A组操作简单 ,手术时间短 ,出血少 ,术后引流量少 ,与B组比较存在显著性差异 (P <0 0 5 )。术后 1年有轻度返流 ,无输尿管梗阻和同侧肾功能影响。肿瘤复发率A、B两组比较无显著性差异。结论　输尿管口附近膀胱肿瘤的改良手术与传统手术相比同样效果满意 ,且操作简单 ,可以推荐

Modified management of bladder cancer near ureteral orifice

Objective To evaluate the surgical treatment of bladder cancer near ureteral orifice. Methods A total of 35 patients with bladder cancer requiring ureteral reimplantation were randomly divided into two groups: A (n=17) and B (n=18). Patients in group A underwent standard incision of bladder cancer and the ureteral orifice was inside-out, but those in group B received partial cystectomy, and the ureter was severed outside the bladder and then implanted into the bladder. The median follow up was 1 year. Bladder ureter reflux, ureter obstruction, renal function, and cancer recurrence rate were studied and compared. Results There was significant difference in operative time, intraoperative bleeding, and postoperative drainage (P<0.05), but no significant difference in bladder ureter reflux, ureter obstruction, renal function, and cancer recurrence rate was found between the two groups. Conclusion Modified incision of bladder cancer near ureteral orifice is technically simple with good results and deserves recommendation.