输尿管末段肿瘤行保肾手术临床效果分析

目的：总结原发性输尿管肿瘤的诊断和治疗经验,提高该病的诊治水平。方法：对12例行保肾手术的原发性输尿管肿瘤患者进行回顾性分析,对不同病理类型肿瘤的预后进行初步评估。结果：12例输尿管末段肿瘤患者经开放手术,10例经输尿管镜手术,2例于电灼前钳取病灶组织,手术后进行病理诊断,其中输尿管移行细胞癌11例（G14例、G25例、G32例）。鳞癌1例。分期为T16例、T24例、T31例、T41例。对本组12例输尿管末段肿瘤患者进行随访6个月～5年,有9例患者获得随访,3例患者失访;9例中术后3个月～3年出现膀胱移行细胞癌6例;术后2年同侧输尿管复发1例;术后1年发现对侧上尿路肿瘤1例。术后5个月发现肺部转移1例鳞癌（T4期）,于术后10个月死亡。结论：影像学联合输尿管镜组织活检是原发性输尿管肿瘤的最佳诊断途径,其预后与病理类型密切相关。保肾手术有复发风险,需进行随访,但对早期、低级别原发性输尿管肿瘤手术效果良好。

Clinical effect analysis of kidneys surgery with ureteral tumor last paragraph

Objective：To summarize the primary ureteral tumor diagnosis and treatment experience and improve diagnosis and treatment of disease.Methods：Retrospectivly analyzed the 12 cases of primary ureteral surgery and kidneys,tumored of different pathological types of tumors a preliminary assessment of the prognosis.Results：12 patients with ureteral tumor last paragraph were treated with open surgery,10 cases were treated with ureteroscopy,2 cases were forceped clip tissue forceps before fulguration,pathological diagnosed after surgery in which 11 cases of transitional cell carcinoma of the ureter（G1 4 cases,G2 5 cases,G3 2 cases）,squamous cell carcinoma in 1 case.The staging was T1 6 cases,T2 4 cases,T3 1 case,T4 1 case.12 cases of ureteral tumor last paragraph patients were followed up for 6 months to 5 years,9 patients were followed up,3 patients were lost to follow;After 3 months to 3 years of transitional cell carcinoma of the bladder oc curred 6 cases in 9 cases,1 case of ipsilateral ureter recurrence after 2 years;1 case of contralateral upper urinary tract tumor after 1 year,1 case of squamous cell carcinoma lung metastasis（T4 period） after 5 months,who was dead after 10 months.Conclusion：Imaging united ureteral mirror biopsy is the best diagnosis primary ureteral tumor way and it is closely related to the prognosis and pathological type.The kidney surgery has the risk of recurrence,needs to undertake followup,but to early,low level of primary ureteral tumor surgery effect is good.