Theodorakis J, Klammert R, Kriegmair M
Urologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
Urologe A. 1994 Jul;33(4):303-7.
Six patients with upper urinary tract tumors were treated in our department with the Nd:-YAG laser between 1989 and 1993. The average follow-up was 23.8 months. The mean age of the patients was 65.7 years. The patients were selected for organ-conserving treatment because of bilateral synchronous tumors (2 cases), a solitary renal unit (2 cases), renal insufficiency with high surgical risk (1 case) and high surgical risk alone (1 case). Two patients were treated with open tumor excision and laser, two patients with ureteroscopic and percutaneous procedures one patient with percutaneous treatment and one patient with ureteroscopy. Two patients underwent nephroureterectomy; one of them died of metastatic bladder cancer 9 months later. Local relapses were observed in one patient who had been treated endoscopically. In a follow-up period of 6-36 months there were three patients who had no relapses. Three patients received intracavitary therapy. Kidney conserving procedures with the Nd:-YAG laser in patients with upper urinary tract tumors should be reserved for highly selected cases.
1989年至1993年间,我科对6例上尿路肿瘤患者采用钕:钇铝石榴石激光进行治疗。平均随访时间为23.8个月。患者的平均年龄为65.7岁。选择这些患者进行器官保留治疗的原因包括双侧同步肿瘤(2例)、孤立肾单位(2例)、手术风险高伴肾功能不全(1例)以及单纯手术风险高(1例)。2例患者接受开放性肿瘤切除和激光治疗,2例患者接受输尿管镜和经皮手术,1例患者接受经皮治疗,1例患者接受输尿管镜检查。2例患者接受了肾输尿管切除术;其中1例9个月后死于转移性膀胱癌。1例接受内镜治疗的患者出现局部复发。在6至36个月的随访期内,有3例患者未复发。3例患者接受了腔内治疗。钕:钇铝石榴石激光在上尿路肿瘤患者中进行肾脏保留手术应仅适用于经过严格筛选的病例。