Loisides P, Grasso M, Lui P
Department of Urology, Loma Linda University Medical Center, CA, USA.
J Endourol. 1995 Aug;9(4):315-7. doi: 10.1089/end.1995.9.315.
Extensive pelvic carcinomatosis often results in bilateral ureteral obstruction and renal parenchymal loss. Percutaneous nephrostomies can be used for palliative means but may be poorly tolerated. Laparoscopic techniques can be applied to obtain a more permanent urinary diversion. An elderly gentleman with extensive pelvic transitional cell carcinoma of the bladder and only one functioning renal unit underwent percutaneous nephrostomy tube placement in combination with palliative cytoreductive radiation therapy. Poor patient tolerance led to repetitive nephrostomy tube replacement. A cutaneous ureterostomy was chosen as a more permanent urinary diversion, and laparoscopic techniques allowed this to be accomplished expeditiously. At 18 months postoperatively, the patient's unstented cutaneous ureterostomy is functioning well, and the serum creatinine concentration remains normal.
广泛的盆腔癌转移常导致双侧输尿管梗阻和肾实质损害。经皮肾造瘘术可用于姑息治疗，但患者耐受性可能较差。腹腔镜技术可用于实现更持久的尿液改道。一位患有广泛膀胱移行细胞癌且仅有一个功能肾单位的老年男性患者，接受了经皮肾造瘘管置入术并联合姑息性减瘤放疗。患者耐受性差导致肾造瘘管反复更换。选择皮肤输尿管造口术作为更持久的尿液改道方式，腹腔镜技术使其得以迅速完成。术后18个月，患者未留置支架的皮肤输尿管造口术功能良好，血清肌酐浓度保持正常。
