CAJ | 학술논문

目的探讨儿童期膀胱移行细胞癌的诊断与治疗特点.方法回顾性分析1970年7月至2011年1月收治的7例膀胱移行细胞癌患儿的临床资料,男5例、女2例,年龄7～16岁,平均约13岁；7例患儿均以间歇、无痛、肉眼全程血尿就诊,其中1例伴排尿困难.其中3例行TUR-BT术,3例患儿行膀胱部分切除术,1例患儿行膀胱部分切除术+输尿管再植术,术后病理检查均为尿路上皮癌,3例术后未作化疗及膀胱灌注治疗,4例术后行膀胱灌注治疗.结果 TUR-BT:手术时间平均30 min,术后3～5 d出院；开放手术时间为70～120 min,术后1周拔除尿管,术后均如期恢复,无并发症发生.7例术后随访8个月至12.5年,平均约61.8个月,无肿瘤复发.结论膀胱移行细胞癌在儿童期较为少见,儿童期排除外伤史、泌尿系结石史、泌尿系感染史及肾病史后反复出现血尿时,应考虑膀胱移行细胞癌可能；结合病史、并积极行影像学和膀胱镜检查可明确诊断；积极的个体化外科治疗方案可取得良好的效果与预后.
목적 탐토인동기방광이행세포암적진단여치료특점.방법 회고성분석1970년7월지2011년1월수치적7례방광이행세포암환인적림상자료,남5례、녀2례,년령7～16세,평균약13세；7례환인균이간헐、무통、육안전정혈뇨취진,기중1례반배뇨곤난.기중3례행TUR-BT술,3례환인행방광부분절제술,1례환인행방광부분절제술+수뇨관재식술,술후병리검사균위뇨로상피암,3례술후미작화료급방광관주치료,4례술후행방광관주치료.결과 TUR-BT:수술시간평균30 min,술후3～5 d출원；개방수술시간위70～120 min,술후1주발제뇨관,술후균여기회복,무병발증발생.7례술후수방8개월지12.5년,평균약61.8개월,무종류복발.결론 방광이행세포암재인동기교위소견,인동기배제외상사、비뇨계결석사、비뇨계감염사급신병사후반복출현혈뇨시,응고필방광이행세포암가능；결합병사、병적겁행영상학화방광경검사가명학진단；적겁적개체화외과치료방안가취득량호적효과여예후.
Objective To retrospectively summarize and analysis clinical characteristics of bladder transitional cell carcinoma in children. Methods Between July 1970 and January 2011, 7 cases of children with bladder transitional cell carcinoma underwent surgery in our department, including 5 boys and 2 girls, and their average age was 13 years old (ranging 7 to 16 years old). Among them 7 cases presented intermittent grossly bloody urine without pain and 1 case was associated with dysuria. All patients were surgically corrected, among them TUR-BT procedure was conducted in 3 cases, partial cystectomy was performed in 3 cases and 1 case underwent partial cystectomy combined with ureterocystostomy. Postoperative pathological examination showed epithelial carcinoma in all patients. Results The mean operating time for TUR-BT procedure was 30 minutes and hospital stay ranged from 3 to 5 days. The open surgery time ranged from 70 to 80 minutes and no complications were found. The follow-up ranged from 8 months to 12.5 years (average 61.8 months), no recurrence was seen in any case. Conclusions Bladder transitional cell carcinoma is rare in children. Recurrent hematuria usually is hint of bladder transitional cell carcinoma once exclusion of traumatic injury, urinary calculi, and infection, as well as renal disease. Cystoscopic examination is helpful for further diagnosis. Intensive individual surgical treatment contributes to satisfactory efficacy.