北京大学学报（医学版）2012，Vol.44Issue(4)：639-642,4.DOI:10.3969/j.issn.1671-167X.2012.04.032
后腹腔镜肾输尿管切除术结合经腹腔下腹正中切口治疗移植肾同侧原上尿路移行细胞癌
Joint therapy of native upper tract transitional cell carcinoma ipsilateral to a transplanted kidney by retroperitoneoscopic nephroureterectomy combined with a midline lower abdominal transperitoneal excision
叶剑飞 1田晓军 1马潞林 1黄毅 1肖春雷 1侯小飞 1赵磊 1王国良 1卢剑 1洪锴1
作者信息
- 1. 北京大学第三医院泌尿外科,北京100191
- 折叠
摘要
Abstract
Objective: To present the preliminary experience of the operative procedure and clinical outcomes of retroperitoneal laparoscopic nephroureterectomy ( RPLNU) with a midline lower abdominal transperitoneal incision for native upper urinary tract transitional cell carcinoma ( UUT-TCC) ipsilateral to a transplanted kidney. Methods: In the study, 15 renal recipients with native UUT-TCC ipsilateral to a transplanted kidney were operated on with RPLNU via a midline lower abdominal transperitoneal incision between November 2005 and January 2009. Retroperitoneal laparoscopic nephrectomy was performed first and followed by cystoscopic excision of ipsilateral ureteral orifice with bladder cuff. A 6 - 8 cm midline lower abdominal incision was made. The distal ureter was dissected transperitoneally into the intramural segment and extracted completely. The intact specimen was removed manually via the same incision. The cystostomy was generally sutured. Results: The mean operation time was 253 minutes. The mean estimated blood loss was 245 mL. Three patients needed blood transfusion. No open conversion was required during the retroperitoneoscopic nephrectomy. Two of the patients suffered from minor complications. The pathological findings confirmed UUT-TCC in all the patients with 9 of the pelvises and 9 of the ureters. Five of the patients were involved with bladder TCC. With the mean follow-up of 35 months, none of them had retroperitoneal recurrence or distant metastasis, 2 of the 5 patients with bladder TCC had recurrence in bladder and 4 had contralateral native UUT-TCC after the first unilateral nephroureterectomy. Conclusion: RPLNU with a midline lower abdominal transperitoneal incision may be a safe and feasible alternative for native UUT-TCC ipsilateral to a transplanted kidney with satisfactory oncologic outcomes.关键词
癌,移行细胞/尿道/腹腔镜检查/肾切除术/肾移植Key words
Carcinoma, transitional cell/ Urethra/ Laparoscopy/ Nephrectomy/ Kidney transplanta-tion分类
医药卫生引用本文复制引用
叶剑飞,田晓军,马潞林,黄毅,肖春雷,侯小飞,赵磊,王国良,卢剑,洪锴..后腹腔镜肾输尿管切除术结合经腹腔下腹正中切口治疗移植肾同侧原上尿路移行细胞癌[J].北京大学学报（医学版）,2012,44(4):639-642,4.
