输尿管部分切除术治疗原发性输尿管癌临床疗效分析（附14例报告）

目的：探讨保留肾脏的输尿管部分切除术治疗原发性输尿管癌的可行性及疗效。方法：回顾性分析2000年4月～2010年4月14例输尿管中下段癌患者行保留肾脏的输尿管部分切除术（治疗组）的临床资料。从术后膀胱癌发生率、疾病特异性生存率等方面与同期29例行输尿管癌根治术（对照组）进行比较。结果：治疗组12例获得随访，术后膀胱癌发生率为16．7％（2／12），疾病特异性生存率1年为91．7％（11／12），5年为75．0％。对照组24例获随访，术后膀胱癌发生率为12．5％（3／24），疾病特异性生存率1年为95．8％（23／24），5年为79．2％。两组术后膀胱癌发生率及1年、5年疾病特异性生存率比较差异均无统计学意义（均P〉O．05）。结论：基于输尿管癌双侧致病同步及异时性特点，在能严格随访的条件下，输尿管部分切除术＋输尿管连续性的重建可以应用于适当选择的中下段输尿管癌患者。

Clinical Analysis of Partial Ureteral Resection for Primary Ureteral Carcinoma(Report of 14 Cases)

Objective:To evaluate the feasibility and effi cacy of partial ureteral resection for primary ureteral car-cinoma.Method:From April 2000 to April 2010,14 cases of primary ureteral carcinoma were retrospectively investigated.This series included 14 cases of primary ureteral carcinoma who had undergone partial ureteral resection, and then restored the continuity of the ureter.The middle ureteral cancer used the ileum restored the continuity of the ureter,and the lower ureteral cancer used the bladder flap restored the continuity of the ureter.And 29 cases who had undergone radical nephroureterectomy for primary ureteral carcinoma(control group)at the same time. The incidence of bladder cancer after operation,the disease specific survival rate were compared between the 2 groups.Result:Follow-up was available in 12 cases of partial ureteral resection group,the incidence of bladder cancer after operation is 16.7%(2/12).the disease specific 1-year survival rate is 91.7%(11/12).and the disease specific 5-year survival rate is 75.0%.Follow-up was available in 24 cases of control group,the incidence of bladder cancer after operation is 12.5%(3/24),the disease specific 1-year survival rate is 95.8%(23/24).the disease specific 5-year survival rate is 79.2%.There was no obvious difference in the incidence of bladder cancer after operation, the disease specific 1-year and 5-year survival rate between the 2 groups(P>0.05).Conclusion:Based on disease characteristics of synchronous and metachronous and bilateral of the ureteral carcinoma,and with strictly follow -up after partial ureteral resection for primary ureteral carcinoma,partial ureteral resection and restore the continuity of the ureter can be used in properly selected patients with middle and lower ureteral carcinomas.