McGinnis D E, Trabulsi E J, Gomella L G, Strup S E
Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA.
Tech Urol. 2001 Mar;7(1):7-11.
Traditional treatment of transitional cell carcinoma of the upper urinary tract (UTTCC) has been nephroureterectomy by open surgical techniques, often requiring two incisions. Our experience and technique for hand-assisted laparoscopic nephroureterectomy (HALNU) is reviewed.
Thirty-two patients had HALNU performed by one of three surgeons from August 1998 to October 2000. The distal ureter and bladder cuff was resected laparoscopically and sutured closed in 15 patients and resected by combined cystoscopic and laparoscopic approach in 17 patients.
The indication for surgery was UTTCC for 29 patients and benign conditions in 2 patients. The mean operating time (including initial cystoscopy) was 372 minutes (281-530), and the mean blood loss was 541 cc (50-3500). The mean hospital stay was 5.5 days (3-12). There were no positive surgical margins, local recurrences, trocar site seeding, or wound seeding.
HALNU is an effective minimally invasive approach for the treatment of UTTCC.
上尿路移行细胞癌（UTTCC）的传统治疗方法是采用开放手术技术进行肾输尿管切除术，通常需要两个切口。本文回顾了我们采用手辅助腹腔镜肾输尿管切除术（HALNU）的经验和技术。
1998年8月至2000年10月，由三位外科医生之一对32例患者实施了HALNU。15例患者经腹腔镜切除远端输尿管和膀胱袖口并缝合关闭，17例患者采用膀胱镜和腹腔镜联合方法切除。
29例患者的手术指征为UTTCC，2例为良性疾病。平均手术时间（包括初始膀胱镜检查）为372分钟（281 - 530分钟），平均失血量为541毫升（50 - 3500毫升）。平均住院时间为5.5天（3 - 12天）。无手术切缘阳性、局部复发、穿刺孔种植或伤口种植情况。
HALNU是治疗UTTCC的一种有效的微创方法。
