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目的:探讨后腹腔镜联合经尿道等离子电切术行肾盂癌根治术治疗肾盂癌的临床疗效。方法:回顾性分析安徽医科大学第一附属医院泌尿外科2008年6月~2012年6月间20例肾盂癌患者住院病例资料。采用后腹腔镜技术行根治性肾输尿管全长切除,联合经尿道等离子电切术切除输尿管开口周围膀胱黏膜。观察患者手术并发症、膀胱内出血、术后肿瘤复发情况。结果:20例手术均成功,无中转开放手术,无大出血、尿瘘并发症。术中出血量、手术时间、术后肛门恢复通气时间、术后开始下床时间及术后住院时间分别为(113.7±59.9)ml、(172.6±23.9)min、(26.4±12.4)h、(28.1±12.6)h及(6.70±0.8)d。所有患者获随访30~60个月,未见穿刺孔,未见膀胱外、腹膜后种植转移,1例膀胱肿瘤复发。结论:后腹腔镜联合经尿道等离子电切术行肾盂癌根治术治疗肾盂癌,有效安全,创伤小,不增加膀胱内复发风险,术后恢复快,并发症少。
Objective: To investigate the clinical effect of retroperitoneal laparoscopic combined with transurethral resection of the prostate in the treatment of renal pelvic cancer. Methods: The data of 20 cases of renal pelvic cancer hospitalized from June 2008 to June 2012 in Department of Urology, First Affiliated Hospital of Anhui Medical University were retrospectively analyzed. Retroperitoneal laparoscopic radical nephroureterectomy was performed and transurethral resection of the bladder mucosa around the ureteral opening was performed. Observe the surgical complications, intravesical hemorrhage, tumor recurrence after surgery. Results: All the 20 surgeries were successful. There was no transit surgery, no major bleeding and complications of urinary fistula. The blood loss, operation time, postoperative anus recovery ventilation time, postoperative bed entry time and postoperative hospital stay were (113.7 ± 59.9) ml, (172.6 ± 23.9) min and (26.4 ± 12.4) h, respectively 28.1 ± 12.6) h and (6.70 ± 0.8) d. All patients were followed up 30 to 60 months, no puncture, no bladder, retroperitoneal metastasis, 1 case of bladder tumor recurrence. Conclusions: Retroperitoneal laparoscopy combined with transurethral resection of the renal pelvis under radical nephroureterectomy for the treatment of renal pelvic cancer is effective, safe and minimally invasive. It does not increase the risk of intravesical recurrence and has rapid postoperative recovery with few complications.