原发性输尿管癌的诊断与治疗（附13例报告）

目的探讨原发性输尿管癌的早期诊断及手术治疗方法，以提高治愈率。方法回顾性分析13例经病理证实的原发性输尿管癌患者的临床资料，并对诊疗问题进行讨论。结果肉眼血尿、腰痛和肾积水是其主要临床表现，彩超、CT、MRI、IVU、膀胱镜检及逆行输尿管插管造影是本病的基本诊断方法；12例患者获得随访，随访时间10个月-7年，死于输尿管癌转移5例，存活7例。结论患侧肾输尿管全长及膀胱袖状切除术是治疗原发性输尿管癌的首选方法，取腰腹部弧形切口先行输尿管及膀胱袖状切除后再向上延长切口作肾切除术，具有成功率高、创伤性小、简便易行、安全可靠等优点。

The diagnosis and treatment of primary ureteral carcinoma (report of 13 cases)

Objective To improve the early diagnosis and operation treatment of primary ureteral carcinoma. Methods Thirteen cases of primary ureteral carcinoma confirmed by pathological examination were retrospectively analyzed, and the problems related to the diagnosis and treatment were discussed. Results Hematuria, flank pain and hydronephrosis were the main signs of the patients. Coloured ultrasonic scanning, CT, MRI, IVU, cystoscopy and retrograde ureteropyelography were the most important diagnostic approaches. Twelve cases were followed up for 10 months to 7 years. Among them,5 died of ureteral carcinoma metastasis and 7 survived. Conclusion Radical nephroureterectomy and bladder cuff resection should be the first choice of treatment for primary ureteral carcinoma, taking the belly arc-shaped slice, performing ureterectomy and bladder cuff resection, then nephrectomy up along the waist. It has the advantages of high success rate, convenience, safety, reliability, effectivity and minimal invasion.