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目的:通过对无法行根治性手术的上尿路上皮肿瘤患者进行腔内红激光治疗情况进行总结,评价该术式的有效性与安全性。方法:对于我院2013年1月到2016年6月期间收治的肾盂、输尿管肿瘤,其中13例行腔内激光手术治疗,分别就术中情况、术后并发症及疗效进行总结。结果:13例患者中,肾盂肿瘤行经皮肾镜激光手术9例,输尿管肿瘤行输尿管镜激光手术4例,平均手术时间分别为(47.22±6.25)min、(25.0±4.84)min;平均出血量分别约为(133.33±24.94)ml、(40.0±7.07)ml;血尿及肾积水情况得到控制,5/13例呈现局部进展,1/13例术后10个月死亡;未出现严重并发症。结论:对于特殊情况下的肾盂、输尿管肿瘤患者,腔内激光手术具有创伤小,止血效果好,可以姑息性切除肿瘤,降低肿瘤负荷,保护肾脏功能,也能减缓肿瘤进展,可以作为这一类患者的首选治疗方案。
OBJECTIVE: To evaluate the efficacy and safety of intraoperative laser red laser treatment of patients with upper urothelial tumors who can not undergo radical surgery. Methods: For renal pelvis and ureter tumors treated in our hospital from January 2013 to June 2016, 13 cases were treated with endovascular laser surgery, and the operative conditions, postoperative complications and curative effects were summarized respectively. Results: Of the 13 patients, renal pelvis tumors were treated by percutaneous nephrolithotomy in 9 cases and ureteral tumors underwent ureteroscopic laser surgery in 4 cases. The mean operative time was (47.22 ± 6.25) min, (25.0 ± 4.84) min, mean bleeding volume (133.33 ± 24.94) ml and (40.0 ± 7.07) ml, respectively. Hematuria and hydronephrosis were controlled, 5 of 13 patients showed local progression, and 1 of 13 patients died after 10 months of operation. There were no serious complications . Conclusion: In special cases of renal pelvis, ureter cancer patients, intracavitary laser surgery with less trauma, hemostatic effect, palliative resection of the tumor, reduce tumor burden, protect renal function, but also can slow tumor progression can be used as this category The patient’s preferred treatment.