腹腔镜肾输尿管全长切除术及膀胱袖状切除术治疗上尿路移行细胞癌

目的:评价腹腔镜经腹腔径路行肾输尿管全长切除术及膀胱袖状切除术治疗上尿路移行细胞癌的有效性及安全性。方法:对6例上尿路移行细胞癌患者行腹腔镜经腹腔径路肾切除术,经同侧下腹斜切口、袖状切除输尿管并完整取出标本。结果:6例手术均获成功,无中转开放手术,手术时间200～320min,平均250min,术中出血100～300ml,均未输血,住院8～12d,平均9d,术后常规膀胱灌注丝裂霉素,随访2～14个月,均无复发或转移。结论:腹腔镜肾输尿管全长切除术是治疗上尿路移行细胞癌安全有效的微创手术,具有痛苦小、康复快等优点。

Laparoscopic total nephroureterectomy with excision of bladder cuff for upper urinary tract transitional cell carcinoma

Objective:To evaluate the safety and efficiency of laparoscopic total nephroureterectomy with excision bladder cuff for upper urinary tract transitional cell carcinoma.Methods:The renals of 6 patients were dissected by translapararoscopic way,then dissention of distal ureter or ureteral carcinoma and bladder cuff of the same lateral was underwent. The entile nephroureterectomy specimens were removed completely. Results: All operation was performed successfully .The operation time was 200 to 320 min(mean 250 min),blood loss was 100 to 300 ml,no blood transfusion.The mean postoperative hospitalization time was 9 days (8 to 12 days).Routine mitomycin bladder irrigation was performed in all patients after operation.There was no recurrence and distal metastasis during 2 to 14 months followup period.Conclusions:Laparoscopic total nephroureterectomy with excision of bladder cuff for upper urinary tract transitional cell carcinoma is a safe and effective procedure for upper urinary tract transitional cell carcinoma with miniinvasive,less pain and rapid recovery.