| 于春虎 田野 成海生 苏书光 毕超 吴京涛.两种不同手术方式处理输尿管末端治疗上尿路肿瘤远期疗效比较[J].,2016,16(17):3276-3278 |
| 两种不同手术方式处理输尿管末端治疗上尿路肿瘤远期疗效比较 |
| Comparison of Efficacy between Different Ways of Operating UreteralOrifice in the Treatment of Upper Urinary Tract Tumor |
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| DOI： |
| 中文关键词: 肾盂肿瘤 输尿管肿瘤 预后 |
| 英文关键词: Carcinoma of renal pelvis Ureteral neoplasm Prognosis |
| 基金项目:首都卫生发展科研专项重点攻关项目（首发2004-2008-09） |
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| 中文摘要: |
| 目的：比较两种不同手术方式处理输尿管末端治疗上尿路肿瘤远期疗效。方法：采用回顾性研究我科后腹腔镜肾输尿管全
长切除术治疗上尿路移行细胞癌的资料，对86例上尿路肿瘤术后患者的临床资料进行分析。A 组：经尿道电切输尿管口53 例，电
切前先电灼患侧输尿管口；B 组：开放手术行输尿管末端膀胱袖套状切除33 例。比较两组术后膀胱癌发生率、局部复发率、远处转
移率以及生存率等指标的差异。结果：经尿道电切输尿管口组患者术后再发膀胱癌19 例(31.1％)；开放手术行输尿管末端膀胱袖
套状切除组患者术后再发膀胱癌10 例(24.4％)。两组术后再发膀胱癌率(x2=0.550，P=0.458)和局部复发率(x2=0.057，P=0.811)比较
差异无统计学意义。经尿道电切输尿管口组患者术后发生远处转移8例(13.1％)，开放手术行输尿管末端膀胱袖套状切除组患者
术后发生远处转移3 例(7.3％)；两组术后远处转移率比较差异无统计学意义(x2=0.360，P=0.549)。经尿道电切输尿管口组患者因肿
瘤死亡20 例，中位生存时间78 个月；开放手术行输尿管末端膀胱袖套状切除组患者因肿瘤死亡18 例，中位生存时间75 个月。
两组患者术后生存率比较差异无统计学意义(x2=1.296，P=0.255)。结论：经尿道电切输尿管口与开放手术行输尿管末端膀胱袖套
状切除两种手术方法处理输尿管末端治疗上尿路肿瘤远期疗效相似。 |
| 英文摘要: |
| Objective:To compare the efficacy of transurethral incision of the ureteral orifice and open excision of bladder cuff in
retroperitoneal laparoscopic nephroureterect for upper urinary tract tumor.Methods:The clinical data of 86 cases of the upper urinary
tract tumor were analyzed. Among the 86 patients, 53 cases (22 males and 31 females) underwent transurethral incision of the ureteral
orifice (TUIUO) (group A), and 33 cases (14 males and 19 females) underwent open excision of bladder cuff (group B). The subsequent
bladder cancer incidence, local carcinoma recurrence rate, distant metastasis rate and survival rate were compared between two groups.Results:Nineteen patients (31.1％) suffered subsequent bladder cancer in transurethral incision of the ureteral orifice (TUIUO) group,
and so did 10 patients (24.4％) in open excision of bladder cuff group. There were no statistical differences in postoperative recurrence
rate of bladder cancer (x2=0.550, P=0.458) and recurrence rate of local cancer (x2=0.057，P=0.811) between the two groups. Eight patients
(13.1％ ) occurred distant metastasis in TUIUO group, and so did 3 patients (7.3％ ) in open excision of bladder cuff group (x2=0.360,
P=0.549). Twenty patients died of carcinoma in TUIUO group, and 18 died in open excision of bladder cuff group. The median survival
time was 78 months in TUIUO group, and 75 months in open excision of bladder cuff group. There was no statistical difference in the
postoperative survival rate (x2=1.296, P=0.255).Conclusion:The efficacy is similar for upper urinary tract tumor by transurethral incision
of the ureteral orifice and open excision of bladder cuff in retroperitoneal laparoscopic nephroureterect. |
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