Orihuela E, Smith A D
Department of Urology, Long Island Jewish Medical Center, New Hyde, New York.
Urol Clin North Am. 1988 Aug;15(3):425-31.
Fourteen selected patients with renal pelvic transitional cell carcinoma were managed percutaneously in our institution between March 1984 and April 1987. With a mean follow-up of 19 months, and excluding those patients who underwent immediate nephroureterectomy, six patients remain free of recurrent disease, which is similar to the results obtained with open parenchyma-sparing conservative operations. Our results suggest that percutaneous operations can provide cure in selected patients, including those with a normal contralateral kidney and with small (no more than 2-cm), single, low-grade, papillary tumors that are confined to the mucosa who, in addition, have negative cytology, negative random biopsies of contiguous mucosa, and no history of or concurrent transitional cell carcinoma elsewhere in the urinary tract. Further, our results suggest that second-look procedures with resection of suspicious residual disease, Nd:YAG laser irradiation of the tumor bed, and intracavitary administration of BCG all appear to help prevent recurrences.
1984年3月至1987年4月期间，我院对14例经挑选的肾盂移行细胞癌患者进行了经皮治疗。平均随访19个月，排除那些立即接受肾输尿管切除术的患者后，6例患者无疾病复发，这与开放性保肾保守手术的结果相似。我们的结果表明，经皮手术可以治愈部分患者，包括对侧肾脏正常、肿瘤较小（不超过2厘米）、单发、低级别、局限于黏膜的乳头状肿瘤患者，此外，这些患者细胞学检查阴性、相邻黏膜随机活检阴性，且无尿路其他部位移行细胞癌病史或并存疾病。此外，我们的结果表明，切除可疑残留病灶的二次探查手术、肿瘤床的钕钇铝石榴石激光照射以及腔内注射卡介苗似乎都有助于预防复发。
