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原发性输尿管癌在泌尿系肿瘤中较为少见。本组原发性输尿管癌8例,在腹腔镜下均顺利完成手术,无1例中转开放手术。手术时间152~216min,平均186.6min;术中出血量10~78ml,平均18.8ml;术中可见肿瘤大小(1.2~1.6)cm×(2.5~3.2)cm,平均1.5cm×2.8cm;术后导尿管留置时间14~21天,平均18.5天;腹膜后负压引流管留置时间3~9天,平均5.2天。术后病理学检查浸润性移行性细胞癌4例,浸润性鳞状细胞癌2例,非浸润性乳头状尿路上皮癌2例。术后行定期化(放)疗6例,拒绝行进一步化(放)疗2例。术后获随访6例,术后6个月复发1例,无死亡病例。术后并发肺部感染5例,未见其他严重并发症。本结果提示,腹腔镜手术切口小、手术时间短、术后恢复快,是治疗原发性输尿管癌的理想术式。
Primary ureteral cancer is less common in urological tumors. The group of 8 cases of primary ureteral cancer, laparoscopic surgery were successfully completed, no one case of open surgery. The operative time was 152-216 minutes with an average of 186.6 minutes. The intraoperative blood loss was 10-78ml with an average of 18.8ml. The size of the tumor was 1.2-1.6cm (2.5-3.2cm) with an average of 1.5cmx2.8cm after operation Urinary catheter indwelling time 14 to 21 days, an average of 18.5 days; retroperitoneal suction tube indwelling time of 3 to 9 days, an average of 5.2 days. Postoperative pathological examination of invasive transitional cell carcinoma in 4 cases, invasive squamous cell carcinoma in 2 cases, non-invasive papillary urothelial carcinoma in 2 cases. Postoperative period (routine) (radiotherapy) in 6 cases, refused to go further (radiotherapy) in 2 cases. Six patients were followed up, one patient recurred after 6 months and no deaths occurred. Postoperative pulmonary infection in 5 cases, no other serious complications. The results suggest that laparoscopic incision small, short operative time, quick recovery, is the ideal surgical treatment of primary ureteral cancer.