癌症2007，Vol.26Issue(11)：1227-1230,4.
盆腔恶性肿瘤术后输尿管下段梗阻的腔镜手术治疗
Endourologic Treatments of Distal Ureteral Obstruction in Patients with History of Pelvic Malignancies:Efficacy and Safety Evaluation
温星桥 1高新 1张勇 2蔡育彬 1邱剑光 1司徒杰 1湛海伦 1王德娟1
作者信息
- 1. 中山大学附属第三医院泌尿外科,广东,广州,510630
- 2. 中山大学附属第三医院核医学科,广东,广州,510630
- 折叠
摘要
Abstract
BACKGROUND & OBJECTIVE: Postoperative tissue adherence, scarring and radiotherapy often lead to extrinsic compression and stricture in the distal ureter of the patients who had history of pelvic malignancies. Our aim was to evaluate the efficacy and safety of endourologic techniques in treating this kind of ureteral obstruction. METHODS: From Jan. 1998 to Mar. 2007, 46 patients with obstruction in the distal ureter and had history of pelvic malignancies underwent endoscopic treatments at the Third Affiliated Hospital of Sun Yat-sen University for relief of the obstruction. Perioperative and follow-up data were analyzed. RESULTS: Of the 46 patients, 25 underwent laparoscopic ureterolysis and ureteroneocystostomy, 18 underwent placement of ureter stent under ureteroscope, 3 underwent percutaneous nephrostomy. No severe complication was recorded. The mean operating time was 82.5 min (range, 30-140 min). The mean blood loss was 45.5 ml (range, 5-180 ml). No blood transfusion was needed. The median follow-up time was 18.2 months (range, 3 months to 6.5 years). Three months after operation, B-ultrasonography and intravenous urography (IVU) showed that 39 (84.8%) patients had recovered normal renal function, the other 7 (15.2%) had hydronephrosis relief and renal function improvement. Nuclear renal scanning showed that the mean postoperative glomerular filtration rate (GFR) in the obstructive kidney was higher than the preoperative level (37.6 ml/min vs. 21.3 ml/min, P＜0.05). No stricture in the uretero-bladder anastomotic stoma was recorded. CONCLUSION: Endoscopic operation is an effective and feasible option for managing some selected kinds of distal ureteral obstruction caused by postoperative tissue adherence and radiotherapy in the patients with history of pelvic malignancies.关键词
腹腔镜/输尿管镜/输尿管梗阻/并发症/外科手术/盆腔肿瘤Key words
Laparoscopy/Ureteroscopy/Ureteral obstruction/ complication/ Surgical operation/ Pelvic neoplasm分类
医药卫生引用本文复制引用
温星桥,高新,张勇,蔡育彬,邱剑光,司徒杰,湛海伦,王德娟..盆腔恶性肿瘤术后输尿管下段梗阻的腔镜手术治疗[J].癌症,2007,26(11):1227-1230,4.
