肾结石合并肾盂癌10例诊治体会

目的]探讨肾结石合并肾盂癌的诊治要点.方法]对本科10例肾结石合并肾盂癌患者的临床资料进行分析.结果]行根治性肾输尿管切除加膀胱袖状切除6例,根治性肾切除加输尿管部分切除3例.1例B超引导下行微创经皮肾镜取石术者术中发现肾盂肿物,二期行根治性肾输尿管切除膀胱袖状切除.10例手术过程顺利,无手术死亡或并发症发生.术后病理报告,移行细胞癌7例、鳞状细胞癌3例.获随访9例,随访时间3～28个月.术后1年内死亡6例,移行细胞癌和鳞状细胞癌各3例.结论]对肾结石病史长的患者,需高度警惕肾盂癌的可能.CT检查对明确诊断肾结石合并肾盂癌具有重要价值.

Diagnosis and Treatment for 10 Cases of Kidney Calculi with Renal Pelvic Carcinoma

Objective]To explore the diagnosis and treatment of kidney calculi with renal pelvic carcinoma. Methods]The clinical data of 10 cases of kidney calculi with renal pelvic carcinoma in our department were analyzed retrospectively. Results]Radical nephroureterectomy and sleeve-like cystectomy was performed in 6 cases. Radical nephrectomy and partial ureterectomy was performed in 3 cases. Renal Pelvis mass was found during the B-ultrasound guided minimally invasive pereutaneous nephrolithotomy（PCNL） for one case and underwent two stage radical nephrouretereetomy combined with sleeve-like cystectomy. Ten patients operated successfully. No death or complications occurred during the surgery. The surgical pathological examination revealed that 7 cases were transitional cell carcinoma and 3 cases were squamous cell carcinoma. Nine cases were followed up for 3 months to 28 months. Six cases including 3 cases of transitional cell carcinoma and 3 cases of squamous cell carcinoma died a year after the surgery. Conclusion] The patients with long medical history of kidney calculi should be highly suspected to be renal pelvic carcinoma. CT scanning has important value for the certain diagnosis of kidney calculi complicated with renal pelvic carcinoma.