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输尿管巨大纤维上皮性息肉的腔内泌尿外科诊断与机器人治疗

Endourologic Diagnosis and Robotic Treatment of a Giant Fibroepithelial Polyp of the Ureter.

作者信息

Cattaneo Francesco, Zattoni Fabio, Meggiato Luca, Valotto Claudio, Dal Moro Fabrizio, Gardiman Marina Paola, Beltrami Paolo, Zattoni Filiberto

机构信息

Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua , Padua, Italy .

Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy.; PhD Course in Clinical and Experimental Oncology and Immunology, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.

出版信息

J Endourol Case Rep. 2016 Oct 1;2(1):172-175. doi: 10.1089/cren.2016.0100. eCollection 2016.

Abstract

Fibroepithelial polyps (FEPs) are a rare cause of ureteropelvic junction (UPJ) obstruction. Radiologists and urologists are not always confident with this disease because of its rarity, complex diagnosis, and heterogeneity of the available treatment options. We present the endourologic diagnosis and the robotic management of a ureteral polyp close to the left UPJ. A 16-year-old woman with a 12 years history of left lumbar pain was referred to our Center. A computed tomography scan detected a left hydronephrosis with no signs of obstructions at MAG-3 scintigraphy. The endourologic evaluation revealed a giant FEP of the left ureter, which was removed surgically with a videolaparoscopic robot-assisted approach. Considering that conventional radiologic imaging techniques can hardly detect a ureteral FEP, an endourologic study of the urinary tract is mandatory to directly observe the polyp. The mini-invasive treatment of ureteral FEPs is feasible and safe, and should be considered as first option in young patients.

摘要

纤维上皮性息肉(FEPs)是输尿管肾盂连接处(UPJ)梗阻的罕见病因。由于其罕见性、复杂的诊断以及可用治疗方案的异质性,放射科医生和泌尿科医生对这种疾病并不总是有信心。我们介绍了一例靠近左UPJ的输尿管息肉的腔内泌尿外科诊断和机器人手术治疗。一名有12年左侧腰痛病史的16岁女性被转诊至我们中心。计算机断层扫描显示左肾积水,MAG-3闪烁扫描未发现梗阻迹象。腔内泌尿外科评估发现左输尿管有一个巨大的FEPs,通过视频腹腔镜机器人辅助方法手术切除。考虑到传统的放射学成像技术很难检测到输尿管FEPs,因此必须进行泌尿系统的腔内泌尿外科检查以直接观察息肉。输尿管FEPs的微创治疗是可行且安全的,对于年轻患者应作为首选。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ee/5098126/b08f7f511652/fig-1.jpg

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