中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
12期
835-838
,共4页
刘士军%张晓威%袁佳奇%叶海云%王晓峰
劉士軍%張曉威%袁佳奇%葉海雲%王曉峰
류사군%장효위%원가기%협해운%왕효봉
上尿路上皮癌%肿瘤分期%膀胱袖状切除%预后
上尿路上皮癌%腫瘤分期%膀胱袖狀切除%預後
상뇨로상피암%종류분기%방광수상절제%예후
Tumors of the upper urinary tract%Tumor staging%Bladder cuff resection%Prognosis
目的 分析低分期肾盂及中上段输尿管尿路上皮癌行根治性肾切除术与经典肾盂癌根治性手术后肿瘤复发率的差异,探讨低分期上尿路上皮癌患者不行膀胱袖状切除的可行性.方法 回顾性分析2000-2007年收治73例上尿路上皮癌患者的资料.男36例,女37例.平均年龄66(45～87)岁.其中肾盂癌46例,中上段输尿管癌27例.根据术式分为经典肾盂癌根治性手术组(35例)和根治性肾切除组(38例).分析2组患者病理及随访结果,比较2组患者术后复发率的差异.结果 经典肾盂癌根治性手术组肿瘤复发8例(22.9%),其中T1患者复发率20.0%(3/15);根治性肾切除组肿瘤复发8例(21.1%),其中T1患者复发率19.0%(4/21),2组总复发率和T1肿瘤复发率差异无统计学意义(P>0.05).经典肾盂癌根治性手术组19例肾盂癌中,肿瘤复发4例(21.1%);16例中上段输尿管癌中,肿瘤复发4例(25.0%),2组肿瘤复发率差异无统计学意义(P>0.05).根治性肾切除组27例肾盂癌中,肿瘤复发3例(11.1%);11例中上段输尿管癌中,肿瘤复发5例(45.5%),2组肿瘤复发率差异有统计学意义(P<0.05).结论 低分期上尿路上皮癌患者可不行膀胱袖状切除术,但肿瘤位于输尿管者应行膀胱袖状切除术.
目的 分析低分期腎盂及中上段輸尿管尿路上皮癌行根治性腎切除術與經典腎盂癌根治性手術後腫瘤複髮率的差異,探討低分期上尿路上皮癌患者不行膀胱袖狀切除的可行性.方法 迴顧性分析2000-2007年收治73例上尿路上皮癌患者的資料.男36例,女37例.平均年齡66(45～87)歲.其中腎盂癌46例,中上段輸尿管癌27例.根據術式分為經典腎盂癌根治性手術組(35例)和根治性腎切除組(38例).分析2組患者病理及隨訪結果,比較2組患者術後複髮率的差異.結果 經典腎盂癌根治性手術組腫瘤複髮8例(22.9%),其中T1患者複髮率20.0%(3/15);根治性腎切除組腫瘤複髮8例(21.1%),其中T1患者複髮率19.0%(4/21),2組總複髮率和T1腫瘤複髮率差異無統計學意義(P>0.05).經典腎盂癌根治性手術組19例腎盂癌中,腫瘤複髮4例(21.1%);16例中上段輸尿管癌中,腫瘤複髮4例(25.0%),2組腫瘤複髮率差異無統計學意義(P>0.05).根治性腎切除組27例腎盂癌中,腫瘤複髮3例(11.1%);11例中上段輸尿管癌中,腫瘤複髮5例(45.5%),2組腫瘤複髮率差異有統計學意義(P<0.05).結論 低分期上尿路上皮癌患者可不行膀胱袖狀切除術,但腫瘤位于輸尿管者應行膀胱袖狀切除術.
목적 분석저분기신우급중상단수뇨관뇨로상피암행근치성신절제술여경전신우암근치성수술후종류복발솔적차이,탐토저분기상뇨로상피암환자불행방광수상절제적가행성.방법 회고성분석2000-2007년수치73례상뇨로상피암환자적자료.남36례,녀37례.평균년령66(45～87)세.기중신우암46례,중상단수뇨관암27례.근거술식분위경전신우암근치성수술조(35례)화근치성신절제조(38례).분석2조환자병리급수방결과,비교2조환자술후복발솔적차이.결과 경전신우암근치성수술조종류복발8례(22.9%),기중T1환자복발솔20.0%(3/15);근치성신절제조종류복발8례(21.1%),기중T1환자복발솔19.0%(4/21),2조총복발솔화T1종류복발솔차이무통계학의의(P>0.05).경전신우암근치성수술조19례신우암중,종류복발4례(21.1%);16례중상단수뇨관암중,종류복발4례(25.0%),2조종류복발솔차이무통계학의의(P>0.05).근치성신절제조27례신우암중,종류복발3례(11.1%);11례중상단수뇨관암중,종류복발5례(45.5%),2조종류복발솔차이유통계학의의(P<0.05).결론 저분기상뇨로상피암환자가불행방광수상절제술,단종류위우수뇨관자응행방광수상절제술.
Objective To evaluate the necessity of concomitant bladder cuff and the possibility of distal ureter sparing surgery during radical nephroureterectomy of low-level upper urinary tract tumors. Methods Clinical data of 73 patients with low-level (Tis-T3 M0 N0 ) tumors of the proximal upper urinary transitional epithelial cancer treated in radical nephroureterectomy in our hospital from 2000 to 2007 were analyzed retrospectively. The medical charts and pathologic specimens of 35 patients with, and 38 patients without, concomitant bladder cuff were reviewed. Results In the 35 patients with concomitant bladder cuff resection, 8 cases (22.9%) recurrence was observed; in the 38 patients without concomitant bladder cuff resection, 8 cases (21.1%) recurrence was observed. There was no difference between both groups(P>0.05). In the 19 patients suffered renal pelvis tumors with concomitant bladder cuff resection, 4 cases (21.1%) recurrence was observed; In the 16 patients suffered ureter tumors with concomitant bladder cuff resection, 4 cases (25 %) recurrence was observed.There is no difference between patients of renal pelvis tumors and of ureter tumors with concomitant bladder cuff(P>0.05). In the 27 patients suffered renal pelvis tumors without concomitant bladder cuff resection, 3 cases (11.1 %) recurrence was observed; in the 11 patients suffered ureter tumors with concomitant bladder cuff, 5 cases (45.5%) recurrence was observed. There was significant different between patients of renal pelvis tumors and of ureter tumors without concomitant bladder cuff (P<0. 05). Conclusion Concomitant bladder cuff resection confers a favorable prognosis to the patients with ureter tumors, but not to the patients with renal pelvis tumors.
