【摘要】 目的探讨应用腹腔镜联合等离子电切镜治疗上尿路肿瘤的临床疗效。方法于2007年1月至2011年6月间应用腹腔镜联合等离子电切镜对34例肾盂肿瘤患者及9例输尿管肿瘤患者进行了上尿路肿瘤根治性切除手术。结果 5例患者在处理下半部输尿管时因剥脱失败而需切口辅助手术,其余38例手术均获得成功,术后患者体表仅存有一约5 cm手术切口及两个穿刺孔。平均手术时间150min。平均出血量150 mL。平均住院时间7.8 d,围手术期无手术并发症。术后病理检查为低级别乳头状尿路上皮癌13例,高级别乳头状尿路上皮癌16例,浸润性尿路上皮癌14例。平均随访13个月未见肿瘤复发及转移。结论腹腔镜联合等离子电切镜治疗浅表性上尿路肿瘤手术方式安全可行,切除肿瘤彻底,创伤小,恢复快,值得临床推广使用。更多还原

【Abstract】 Objective To discuss the clinical effect in treatment of laparoscopy combined with plasma kinetic vaporized resectoscope on upper urinary tract cancer.Methods From January 2007 to June 2011,34 patients with renal pelvis tumors and 9 patients with ureter tumors were treated by radical resection of upper urinary tract cancer,via the method of laparoscopy combined with plasma kinetic vaporized resectoscope.Results Five patients had to have auxiliary incision operations when denudation of lower ureter failed.The operations on 38 patients were successful,leaving only 5 cm cut and 2 punctured apertures on the surface of the patients.The average time of operation was 150 min.The average amount of bleeding was 150 mL and the average time of hospitalization was 7.8 d.No complications occurred during the perioperative period.Post-operation pathologic diagnoses were: 13 cases of papillary urothelial cancer in G1 stage,16 cases of papillary urothelial cancer in G2 stage,14 cases of invasive urothelial cancer.During 13 months’ follow-up,no local relapse and metastasis occurred.Conclusion It is feasible and safe to apply the therapy of laparoscopy combined with plasma kinetic vaporized resectoscope.It is advisable to develop and adopt the method optionally,owing to its advantages in the thorough resection of cancer,with minor wound and quick recovery.更多还原