肾移植术后并发泌尿系统肿瘤8例报告

目的总结肾移植术后并发泌尿系统肿瘤的诊治体会。方法8例患者在肾移植术后3-16年出现间歇性血尿,通过B超、静脉尿路造影（IVU）、膀胱镜、输尿管镜、逆行肾盂造影、CT及内窥镜下取材活检等,证实1例为肾盂肿瘤,3例为输尿管肿瘤,3例为膀胱肿瘤,1例为尿道肿瘤。肾盂肿瘤和输尿管肿瘤的5例均采取肾、输尿管全程及膀胱部分切除术;3例膀胱肿瘤患者中,2例行经尿道膀胱肿瘤电切术,1例膀胱全切术,在行肿瘤切除术前后需适当调整免疫抑制治疗方案。术后通过膀胱灌注给予丝裂霉素、吡柔比星、表阿霉素等进行化疗。结果1例患者因肿瘤复发或新发而接受了二次肿瘤切除术,1例发生肺转移;8例患者10次手术均顺利,治疗效果满意。结论对肾移植术后并发泌尿系统肿瘤的患者,关键在于早期诊断、积极治疗,应慎重对待肾移植术后出现血尿的患者,以免漏诊。

Diagnosis and treatment of urologic neoplasms of kidney recipients following renal transplantation

Objective To summarize the experience of diagnosis and treatment of urologic neoplasms of kidney recipients following renal transplantation. Methods From April 1990 to Aug. 2006, about over 1 500 kidney transplantations were performed and 8 patients were diagnosed as renal tumors by B-ultrasound, IVU, cystoscopy, and CT etc, including 1 case of renal pelvis tumor, 3 cases of ureter tumor and 3 cases of cyst tumor, and 1 case of penis tumor. Corresponding surgical operations were performed. Results All operations were successful and most patients got satisfactory results. Conclusion Kidney recipients have a higher rate of transitional cell carcinoma. Kidney recipients with hematuria should be examined carefully with cystoscopy, retrograde pyelography and cystourethroscopy.