Nesa S, Cosyns J P, Saleh A, Wese F X, Opsomer R J, Dardenne A, Lorge F, Van Cangh P J
Service d'Urologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain.
Acta Urol Belg. 1995 Mar;63(1):43-51.
In our Institution, 23 patients were selected for percutaneous resection of tumors of the upper urinary tract. Two patients underwent a second procedure: the first for ipsilateral recur and the second for an heterolateral tumor. Among these 23 patients, 11 presented a benign tumor, 9 were treated for a transitional carcinoma of whom 2 invasive state. Both underwent a nephro-ureterectomy. For the 7 superficial transitional carcinomas, the mean follow-up period is 30.4 months. The ipsilateral local recurrencee is 14.3% (1/7), and concern a poorly differentiated tumor (G III). The advantage of the endoscopic techniques to explore and treat the upper urinary tract tumors is double. With these techniques, we can diagnose and treat adequately benign tumors which don't justify radical surgery. In the case of transitional tumors, the percutaneous way is an acceptable method of management when it appears better to avoid a radical treatment (solitary kidney, bilateral synchronous tumors, impairment of total renal function, general injuries). However, it must be performed only in selected cases, and patients should be carefully selected.
在我们机构，23例患者被选来行经皮上尿路肿瘤切除术。2例患者接受了第二次手术：第一例是同侧复发，第二例是异侧肿瘤。在这23例患者中，11例为良性肿瘤，9例接受了移行细胞癌治疗，其中2例处于浸润状态，均接受了肾输尿管切除术。对于7例浅表性移行细胞癌，平均随访期为30.4个月。同侧局部复发率为14.3%（1/7），涉及1例低分化肿瘤（G III级）。内镜技术用于探查和治疗上尿路肿瘤有双重优势。通过这些技术，我们可以充分诊断和治疗无需根治性手术的良性肿瘤。对于移行性肿瘤，当似乎最好避免根治性治疗（孤立肾、双侧同步肿瘤、总肾功能损害、全身损伤）时，经皮途径是一种可接受的治疗方法。然而，它必须仅在特定病例中进行，并且患者应仔细挑选。
