Lam John S, Bingham Jonathan B, Gupta Mantu
Department of Urology, New York-Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
Urology. 2003 Nov;62(5):810-3. doi: 10.1016/s0090-4295(03)00691-5.
To report our experience on the endoscopic treatment of large fibroepithelial polyps of the renal pelvis and ureter. Fibroepithelial polyps of the upper urinary tract are rare benign tumors that have traditionally been treated by open exploration and resection.
Five patients underwent either percutaneous or ureteroscopic treatment of a renal pelvic or ureteral fibroepithelial polyp by electroresection or holmium:yttrium-aluminum-garnet laser resection.
All 5 patients were without recurrence after endoscopic resection. The mean follow-up was 19.6 months (range 6 to 41). The average length of stay was 3 days (range 2 to 5) and 0.5 day (range 0 to 1) for those undergoing percutaneous and ureteroscopic treatment, respectively. No major complications resulted from either approach, and no ureteral strictures have developed. All patients treated remain recurrence free.
Endoscopic management of large fibroepithelial polyps of the renal pelvis and ureter is an acceptable treatment modality with minimal morbidity and durable treatment results. The percutaneous approach offers the advantage of identifying the base of the polyp under direct visualization, allowing safe destruction of the stalk and efficient removal of the entire polyp. To our knowledge, this is the first reported series of percutaneous, antegrade excision of fibroepithelial polyps.
报告我们对肾盂和输尿管大纤维上皮性息肉进行内镜治疗的经验。上尿路纤维上皮性息肉是罕见的良性肿瘤，传统上通过开放探查和切除进行治疗。
5例患者接受了经皮或输尿管镜下电切或钬:钇铝石榴石激光切除肾盂或输尿管纤维上皮性息肉的治疗。
所有5例患者内镜切除后均无复发。平均随访19.6个月（范围6至41个月）。经皮治疗和输尿管镜治疗患者的平均住院时间分别为3天（范围2至5天）和0.5天（范围0至1天）。两种方法均未导致严重并发症，也未出现输尿管狭窄。所有接受治疗的患者均无复发。
肾盂和输尿管大纤维上皮性息肉的内镜治疗是一种可接受的治疗方式，发病率极低且治疗效果持久。经皮方法的优点是在直视下识别息肉基部，能够安全地破坏蒂部并有效切除整个息肉。据我们所知，这是首次报道的经皮顺行切除纤维上皮性息肉的系列病例。
