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目的探讨后腹腔镜联合尿道电切镜根治性肾输尿管切除治疗上尿路移行细胞癌的方法和临床疗效。方法对10例肾盂癌、6例输尿管上中段移行细胞癌先采用尿道电切镜行患侧输尿管口膀胱黏膜袖套状切除,而后行后腹腔镜根治性肾输尿管全切术。结果16例手术均获成功,平均手术时间120 min,术中出血平均80 ml,患者均于术后36～48 h下床活动,术后住院时间8～14 d(平均9.4 d),术后随访膀胱局部复发2例。结论后腹腔镜联合尿道电切镜根治性肾输尿管切除治疗上尿路肿瘤是一种安全、有效的微创手术方法,实用性较强,具有良好的应用前景。
Objective To investigate the method and clinical efficacy of retroperitoneal laparoscopic combined with urethral resection radical nephroureterectomy in the treatment of upper urinary tract transitional cell carcinoma. Methods 10 cases of renal pelvic cancer and 6 cases of upper ureter transitional cell carcinoma were treated with cuff resection of ureteric urethral mucosa by urethral resection and retroperitoneal laparoscopic radical nephroureterectomy. Results The operation was successful in all 16 cases. The average operation time was 120 min and the mean intraoperative bleeding was 80 ml. The patients were all allowed to get out of bed after 36-48 h. The postoperative hospital stay was 8-14 days (mean, 9.4 days) Two cases of local bladder recurrence were followed up. Conclusions Retroperitoneal laparoscopic radical urethral resection of radical nephroureterectomy for the treatment of upper urinary tract tumors is a safe and effective method of minimally invasive surgery, which has strong practicability and good application prospect.