输尿管镜结合钬激光技术治疗孤立肾上尿路尿路上皮癌3例报告

目的总结输尿管镜结合钬激光技术治疗孤立肾上尿路尿路上皮癌的诊治体会。方法回顾性分析3例孤立肾上尿路尿路上皮癌患者的临床资料和随访结果。3例均为女性,1例输尿管癌,其对侧肾萎缩无功能;1例肾盂癌,曾因对侧输尿管癌接受肾输尿管全长切除术;1例为移植肾肾盂癌。3例患者均接受输尿管镜钬激光治疗。结果术后平均随访2年,3例患者均存活,其中1例无复发,1例因对侧萎缩肾一侧发生输尿管癌而再次接受输尿管镜钬激光治疗,术后无复发,1例因移植肾肾盂癌伴膀胱癌复发接受肾输尿管及膀胱切除术。结论对于解剖性或功能性孤立肾上尿路尿路上皮癌,输尿管镜结合钬激光技术是一种可选择方法,但术后应密切随访。

Ureteroscopic treatment for carcinomas of upper urinary tract using holmium laser (report of 3 cases)

Objective To investigate the indications,feasibility and safety of ureteroscopic treatment for carcinomas of upper urinary tract using holmium laser.Methods Data of 3 cases were retrospectively reviewed.The 3 cases were all female.1 had renal atrophy and loss of function in the contralateral side,1 had received nephroureterectomy in the contralateral side and 1 was renal recepient.Ureteroscopic laser treatment was performed successfully for the treatment of ureteral carcinoma in 1 patient and renal pelvic carcinomas in 2 patients.Results During the followup of 2 years,1 patient remained tumor free.1 received nephroureterectomy and cystectomy because of tumor recurrence in the transplanted renal pevis and bladder.1 received another ureteroscopic treatment because of tumor recurrence in the contralateral ureter.Conclusions As to the carcinomas of upper urinary tract in patients with solitary kidney or with poor renal function in the contralateral side,ureteroscopic treatment for carcinomas using holmium laser is a safe and feasible choice,but strict postoperative surveilence is needed.