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采用腹腔镜肾输尿管切除术并在术中临时阻断髂内动脉治疗盆腔动静脉畸形,输尿管癌治疗成功。

Ureteral cancer successfully treated with laparoscopic nephroureterectomy with temporary intraoperative occlusion of the internal iliac artery for pelvic arteriovenous malformation.

作者信息

Koyama Juntaro, Sato Tomonori, Sato Yasufumi, Sato Shin, Shimada Shuichi, Taniuchi Shinji, Tsuchida Ken, Tsuboi Masahiro, Sakamoto Kazuhiro, Ikeda Yoshihiro

机构信息

Department of Urology Osaki Citizen Hospital Osaki Japan.

Department of Urology Tohoku University Graduate School of Medicine Sendai Japan.

出版信息

IJU Case Rep. 2024 Sep 6;7(6):467-470. doi: 10.1002/iju5.12780. eCollection 2024 Nov.

Abstract

INTRODUCTION

Pelvic arteriovenous malformation is often a source of intraoperative bleeding. Here, we report our experience with a case of ureteral cancer with pelvic arteriovenous malformation treated using laparoscopic nephroureterectomy with temporary intraoperative occlusion of the internal iliac artery.

CASE PRESENTATION

A 75-year-old man presented to our hospital with asymptomatic macro-hematuria. Contrast-enhanced computed tomography revealed right ureteral tumor with no apparent metastases, and right pelvic arteriovenous malformation. Three months later, multiple bladder cancers were identified and the patient underwent trans-urethral resection of bladder tumor. The pathological diagnosis was urothelial carcinoma, pTa. We performed right laparoscopic nephroureterectomy with temporary intraoperative occlusion of the internal iliac artery. There was little intraoperative bleeding, and the surgery was safely completed. The pathological diagnosis was urothelial carcinoma, pT2 + Tis.

CONCLUSION

A patient showing ureteral cancer with pelvic arteriovenous malformation was safely treated using laparoscopic nephroureterectomy with temporary occlusion of the internal iliac artery.

摘要

引言

盆腔动静脉畸形常常是术中出血的一个来源。在此,我们报告一例输尿管癌合并盆腔动静脉畸形患者,采用腹腔镜肾输尿管切除术并在术中临时阻断髂内动脉的治疗经验。

病例介绍

一名75岁男性因无症状肉眼血尿就诊于我院。增强计算机断层扫描显示右侧输尿管肿瘤,无明显转移,以及右侧盆腔动静脉畸形。三个月后,发现多处膀胱癌,患者接受了经尿道膀胱肿瘤切除术。病理诊断为尿路上皮癌,pTa期。我们实施了右侧腹腔镜肾输尿管切除术并在术中临时阻断髂内动脉。术中出血很少,手术安全完成。病理诊断为尿路上皮癌,pT2+Tis期。

结论

对于表现为输尿管癌合并盆腔动静脉畸形的患者,采用腹腔镜肾输尿管切除术并临时阻断髂内动脉可安全地进行治疗。

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