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[内镜检查在上尿路肿瘤的诊断和治疗中起什么作用?]

[What is the role of endoscopy in the diagnosis and treatment of tumors of the upper urinary tract?].

作者信息

Gelet A, Ballanger P, Abbar M, Viguier J L, Marechal J M

机构信息

Service d'Urologie et Chirurgie de la Transplantation, hôpital Edouard Herriot, Lyon.

出版信息

Prog Urol. 1991 Apr;1(2):245-60.

PMID:1844826
Abstract

17 patients with upper urinary tract tumours were investigated by endoscopy. 3 patients (Group I) with fibrous or fibroepithelial polyps were treated via a retrograde approach and did not develop any recurrences. 2 patients (Group II) developed unexplained haematuria: the diagnosis of high-grade carcinoma was confirmed by endoscopy and they were treated by nephroureterectomy. 12 patients (Group III) with low grade non-invasive urothelial carcinoma, in whom radical surgical was not indicated, were treated conservatively via the percutaneous (13 tumours) or retrograde (1 tumour) endoscopic approach. The local recurrence rate was 33% (4 out of 12 tumours) for a mean follow-up of 22 months. The recurrences were treated by repeated endoscopy in 3 patients, and by nephroureterectomy in 1 patient. Endoscopic treatment of upper urinary tract tumours should be reserved for benign tumours and selected cases of low-grade, non-invasive urothelial carcinoma.

摘要

对17例上尿路肿瘤患者进行了内镜检查。3例(第一组)患有纤维性或纤维上皮性息肉的患者采用逆行方法治疗,未出现任何复发。2例(第二组)出现不明原因血尿:经内镜检查确诊为高级别癌,并行肾输尿管切除术。12例(第三组)低级别非浸润性尿路上皮癌患者,因不适合行根治性手术,采用经皮(13个肿瘤)或逆行(1个肿瘤)内镜方法进行保守治疗。平均随访22个月,局部复发率为33%(12个肿瘤中的4个)。3例复发患者通过重复内镜治疗,1例通过肾输尿管切除术治疗。上尿路肿瘤的内镜治疗应仅限于良性肿瘤和部分低级别、非浸润性尿路上皮癌病例。

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