完全后腹腔镜下肾盂输尿管癌根治性切除术

目的 探讨完全后腹腔镜下肾盂输尿管癌根治性切除术的手术方法及临床应用价值。方法 2003年3月-2005年12月对16例肾孟输尿管癌患者行完全后腹腔镜下根治性切除术。男10例，女6例，肾盂癌11例。输尿管癌5例。均因无痛性肉眼全程血尿就诊。经KUB＋IVP、CT、BUS、逆行上尿路插管造影及输尿管镜检诊断肾盂或输尿管癌。结果 16例手术均取得成功，无中转开放者，手术时间120～200min，平均150mill；术中出血60～120mL，平均70mL；术后住院天数7～10d，平均8d；术中术后无明显并发症，术后随诊3～30个月，未见局部肿瘤复发及膀胱内新发肿瘤。结论 完全后腹腔镜下肾盂输尿管癌根治性切除术方法可行，疗效肯定，具有微创、术后恢复快等优势，将成为治疗上尿路移行细胞癌较理想的手术方法。

Totally retroperitoneoscopic nephroureterectomy for transitional cell carcinoma of the renal pelvis and ureter

[Objective] To evaluate the method of surgical technique and clinical value of the totally retroperitoneoscopic nephroureterectomy for transitional cell carcinoma of the renal pelvis and ureter. [Methods] From March 2003 to December 2005, 16 cases of transitional cell carcinoma of the renal pelvis and ureter, male 10 and female 6, renal pelvic carcinoma 11 and carcinoma of ulreter 5, underwent totally retroperitoneoscopic radical nephroureterectomy. All of them went to hospital because of painless total gross hematuria. Diagnosis was based on KUB+IVP, CT, BUS, retrograde catheterization opacification of upper urinary tract and ureteroscope. [Results] All cases were finished successfully. None was converted to open surgery. Mean operation time was 150 min (range120~200 min); mean blood lose was 70 mL (range 60~120 mL); The postoperative hospital stay was 7~10 days (mean of 8 days). All patients had no obvious complication during operation or postoperative period. No case of local or systemic relapse and new tumor of the bladder were observed by follow-up of three-thirty months. [Conclusion] The method of totally retroperitoneoscopic nephroureterectomy for transitional cell carcinoma of the renal pelvis and ureter is feasible and effective. And it has the advantages of minimal invasion and rapid recovery compared with open surgery. It's becoming an ideal surgical technique for transitional cell carcinoma of upper urinary tract.