Guliev B G, Komyakov B K, Al-Attar T Kh
Department of Urology, I.I. Mechnikov North-Western State Medical University, Saint Petersburg.
Urologiia. 2016 Apr(2):104-108.
To analyze the results of surgical treatment of patients with long ureteral fibroepithelial polyps (FEP).
From 2005 to 2014 three patients (1 man and 2 women) with large FEP were observed in our hospital. In 2 patients the base of the polyp was located in the proximal ureter and in 1 patient in the middle calyx of the single kidney. The fibroepithelial polyps were long and extended down to the lower third of the ureter (2) or protruded into the bladder (1). Endoscopic resection of the polyp was made in 1patient, resection of parenchyma in the middle calyx along with the base of FEP in 1 patient with the single kidney, and another patient underwent laparoscopic nephrectomy due to the absence of kidney function.
Endoscopic resection was successful; the operation lasted 45 minutes without complications. In the patients with a single right kidney operative time was 3.5 hours; during the operation, she received a blood transfusion. In the postoperative period, she underwent two hemodialysis sessions due to acute renal failure. Subsequently, her kidney function was restored. No FEP recurrences occurred in cases of organ sparing operations during follow-up. The postoperative period of the third patient submitted to laparoscopic nephrectomy was uneventful, creatinine levels remained in the normal range.
For long, large ureteral FEPs with a broad base the choice of surgical option depends on possibility of tumor visualization and functional state of the kidney.
分析长段输尿管纤维上皮息肉（FEP）患者的手术治疗结果。
2005年至2014年，我院观察了3例（1例男性和2例女性）患有大型FEP的患者。2例患者息肉基底部位于输尿管近端，1例患者息肉基底部位于单肾的中盏。纤维上皮息肉较长，向下延伸至输尿管下三分之一处（2例）或突入膀胱（1例）。1例患者行息肉内镜切除术，1例单肾患者行中盏实质连同FEP基底部切除术，另1例因肾功能丧失行腹腔镜肾切除术。
内镜切除成功；手术持续45分钟，无并发症。右侧单肾患者手术时间为3.5小时；术中接受输血。术后因急性肾衰竭进行了两次血液透析。随后，其肾功能恢复。随访期间，保留器官手术的病例未发生FEP复发。接受腹腔镜肾切除术的第3例患者术后恢复顺利，肌酐水平保持在正常范围内。
对于基底部较宽的长段、大型输尿管FEP，手术方式的选择取决于肿瘤可视化的可能性和肾脏的功能状态。
