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目的:分析保留肾脏手术治疗原发性输尿管癌的治疗效果。方法:回顾性分析我院2007年1月～2015年12月行输尿管癌手术患者的临床资料,其中行保留肾脏手术治疗原发性输尿管癌患者共12例,其中11例单发,1例双侧同时发病;位于下段肿瘤12例,中段1例;行输尿管下端及膀胱袖口状切除、输尿管膀胱再植术5例,输尿管镜下钬激光腔内切除5例,行输尿管节段切除、输尿管端端吻合术1例,1例双侧输尿管下段肿瘤患者行双侧输尿管节段切除+输尿管皮肤造口术。术中均留置输尿管支架管,术后1个月拔出,9例术后行膀胱灌注。结果:全部患者均为尿路上皮癌。术后随访3～108个月,平均(48.08±32.75)个月,术后总体复发率为54.55%(6/11),平均无瘤生存时间为(24.2±19.46)个月,2年内膀胱癌发生率为9.0%;2年总体生存率为81.81%(9/11),5年生存率为54.54%(6/11)。结论:保留肾脏手术治疗原发性输尿管癌安全、可行、有效,但术后需严密监测随访,包括输尿管镜检查。
Objective: To analyze the effect of preserving renal surgery on primary ureteral cancer. Methods: The clinical data of patients with ureteral carcinoma underwent surgery in our hospital from January 2007 to December 2015 were retrospectively analyzed. Among them, 12 cases of primary ureteral cancer underwent renal surgery, of which 11 were single and 1 was double Side at the same time; located in the lower segment of the tumor in 12 cases, the middle one case; line lower ureter and bladder cuff resection, ureter bladder replantation in 5 cases, ureteroscopic holmium laser resection in 5 cases, ureteric segmentectomy, ureter End anastomosis in 1 case, 1 case of bilateral lower ureteral tumors in patients with bilateral ureteral resection + ureteral skin ostomy. Intraoperative ureteral stent catheter indwelling, pull out after 1 month, 9 cases were performed bladder irrigation. Results: All patients had urothelial carcinoma. The patients were followed up for 3 to 108 months with an average of (48.08 ± 32.75) months. The overall recurrence rate was 54.55% (6/11) and the mean tumor-free survival time was (24.2 ± 19.46) months. The incidence of bladder cancer The overall survival rate at 2 years was 81.81% (9/11), and the 5-year survival rate was 54.54% (6/11). Conclusion: Retention of renal surgery for the treatment of primary ureteral cancer is safe, feasible and effective, but follow-up should be closely monitored after operation, including ureteroscopy.