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目的 :评价腹腔镜根治性肾输尿管切除术治疗上尿路移行细胞癌的有效性和安全性。方法 :对 2 6例上尿路肿瘤患者 ,其中 2例曾有同侧肾移植史 ,行腹腔镜根治性肾输尿管切除及膀胱黏膜袖套状切除术 ,并记录其有关指标。结果 :2 6例均手术成功 ,其中 3例采用经腹腔途径 ,2 3例经后腹腔途径。平均手术时间 1 2 0min ,术中出血量 4 6ml,术后住院时间 1 0 .5d ,恢复正常活动时间 4 .1周。 2 0例随访 6～ 38个月 ,1例局部腹膜后肿瘤复发 ,1例膀胱内复发 ;无远处转移及穿刺通道的种植性转移。结论 :腹腔镜根治性肾输尿管切除术治疗上尿路移行细胞癌是安全、有效的微创手术方法 ,但其对肿瘤细胞生物学行为的影响尚需作进一步的评价
Objective: To evaluate the effectiveness and safety of laparoscopic radical nephroureterectomy in the treatment of upper urinary tract transitional cell carcinoma. Methods: Twenty-six patients with upper urinary tract tumors, two of whom had a history of ipsilateral renal transplantation, underwent laparoscopic radical nephroureterectomy and cuff resection of bladder mucosa, and recorded the relevant indicators. Results: Twenty - six cases were successfully operated. Three of them were treated by peritoneal approach and 23 by retroperitoneal approach. The average operation time was 120 minutes, the intraoperative blood loss was 46ml, the postoperative hospital stay was 10.5 days, and the normal activity time was restored to 4.1 weeks. Twenty cases were followed up for 6 to 38 months. One case had recurrent retroperitoneal tumor and one case had intravesical recurrence. There was no distant metastasis and implanted metastasis of the puncture channel. Conclusion: Laparoscopic radical nephroureterectomy for the treatment of upper urinary tract transitional cell carcinoma is a safe and effective method of minimally invasive surgery. However, its effect on the biological behavior of tumor cells needs to be further evaluated