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目的:提高双侧上尿路移行细胞癌的诊断率并探讨双侧上尿路同时发生移行细胞癌患者的治疗策略。方法:报告5例双侧上尿路同时发生移行细胞癌患者的临床资料,均有无痛性全程肉眼血尿,有2例肾功不全,4例术前行B超、IVP、CTU及逆行造影检查,2例术前获得诊断,2例一侧仅表现异常,术中获得确诊。4例均行保肾手术。1例在外院仅诊断一侧肿瘤,并行根治性切除术,20天后又在我院确诊对侧也存在肿瘤并行保肾手术。结果:随访14～40个月,平均26个月。随访期间1例死亡,2例术后发生膀胱肿瘤,2例未见肿瘤复发。结论:双侧上尿路同时发生移行细胞癌易漏诊一侧,保肾手术是治疗的最优选择。
Objective: To improve the diagnostic rate of bilateral upper urinary tract transitional cell carcinoma and to explore the treatment strategy of bilateral upper urinary tract concurrent patients with transitional cell carcinoma. Methods: The clinical data of 5 patients with bilateral upper urinary tract concurrent transitional cell carcinoma were reported. All of them had painless gross hematuria, 2 cases of renal insufficiency, 4 cases preoperative B-ultrasound, IVP, CTU and retrograde angiography Examination, 2 cases were diagnosed preoperatively, 2 cases only showed abnormal side, intraoperative confirmed. 4 cases underwent kidney surgery. Only one case of diagnosis of tumor in the outer hospital, parallel radical resection, and 20 days later in our hospital diagnosed contralateral side there are also tumor retention kidney surgery. Results: Follow-up 14 to 40 months, an average of 26 months. One patient died during follow-up, 2 had bladder tumor after operation, and 2 had no tumor recurrence. Conclusion: The bilateral upper urinary tract concurrent transitional cell carcinoma is easy missed diagnosis side, kidney surgery is the best choice for treatment.