The Smith Institute for Urology, Department of Urology, Zucker School of Medicine at Hofstra/Northwell , New Hyde Park, New York.
J Endourol. 2018 May;32(S1):S10-S16. doi: 10.1089/end.2018.0036.
Endoscopic management of upper tract urothelial carcinoma has become more popular over the last few decades as there has been an impetus for renal preservation in these patients. While radical nephroureterectomy has been the gold standard in treatment of this disease, ureteroscopic and percutaneous management has become a viable option for select patients.
The literature on endoscopic management of upper urinary tract tumors was explored. Different management methods are discussed, both from published literature and experience of the authors of this chapter.
We review the indications, details of the procedure, and troubleshooting methods in the endoscopic management of upper tract urothelial carcinoma. Imperative indications as well as controversial indications are discussed. The role and efficacy of adjuvant intrarenal topical agents are examined as well as the protocol for administering these agents. Follow-up protocols are also reviewed.
In select patients, endoscopic management with ureteroscopy and/or percutaneous resection of upper tract urothelial tumors is appropriate and can preserve renal function while obtaining comparable oncologic control compared with radical surgery.
在过去几十年中，由于人们对这些患者的肾脏保护有了强烈的需求，因此内窥镜上尿路尿路上皮癌的治疗方法变得越来越流行。虽然根治性肾输尿管切除术一直是治疗这种疾病的金标准，但输尿管镜和经皮治疗已成为某些患者的可行选择。
探讨了上尿路肿瘤内窥镜治疗的文献。讨论了不同的治疗方法，既有来自已发表文献的，也有来自本章作者的经验。
我们回顾了上尿路尿路上皮癌内窥镜治疗的适应证、手术细节和故障排除方法。讨论了强制性适应证和有争议的适应证。还检查了辅助肾内局部药物的作用和疗效，以及给予这些药物的方案。还回顾了随访方案。
在选择的患者中，内窥镜治疗（包括输尿管镜检查和/或经皮切除）治疗上尿路尿路上皮肿瘤是合适的，与根治性手术相比，它可以保留肾功能，同时获得相当的肿瘤控制效果。
