摘要
目的探讨肾盂输尿管癌术后膀胱灌注化疗对膀胱复发癌的影响。方法对96例获随访的原发性肾盂输尿管癌患者的临床资料进行回顾性研究总结。结果行肾盂输尿管膀胱部分切除术术后未进行膀胱灌注化疗的患者膀胱癌复发率为34．4％（11／32），术后行膀胱灌注化疗者膀胱癌复发率为18．8％（12／64），差异有显著性意义（P〈0．05）。术后24小时内行膀胱灌注化疗者膀胱肿瘤术后复发率17．2％（5／29）小于术后2周行膀胱灌注化疗者20％（7／35），两者相比较，差异无显著性意义（P〉0．05）。术中先行输尿管末端结扎者术后膀胱癌复发率较未采取结扎措施者低，但两者相比未见统计学意义（p〉0．05）。结论肾盂输尿管癌行肾输尿管膀胱部分切除术后预防性膀胱灌注化疗可有效降低复发性膀胱癌的发生率。术中游离肾输尿管前行输尿管末端结扎并同时行预防性膀胱灌注化疗对预防肾盂输尿管癌术后再发膀胱癌可能有效。
Objectives To investigate the influence of irrigation of bladder to the recurrence of bladder tumors after surgery of upper urinary tract transitional cell carcinoma of the upper urinary tract. Methods The 96 patients who underwent total nephroureterectomy for clinically localized transitional cell carcinoma of the upper urinary trace, All of them were followed up and their data were retrospectively analyzed. Results After nephroureterectony and resection of partial bladder wall, the bladder transitional cell carcinoma （ TCC ） recurrence rate was 34.4% （11/32） in pntient who bad rejected adoption intravesical chemotherapy , being obviously higher than patient who adoption intravesical chemotherapy 18.8% （12/64, p 〈 0.05 ）. The recurrence rates in those who had prophylactic intravesical instillation 24 hours after surgery, and in those who had the instillation 2 weeks after surgery were 17. 2% （5/29） and 20% （7/35） , respectively. There was no significant difference between them （ p 〉 0.05 ）. The bladder TCC recurrence rates in patient whose ureter had been ligated before the kidney was dissociated lower than whose ureter had not been ligated. Although the difference was not statistically significant the result demonstrated a strong trend that this surgery method may contribute to prevent the bladder TCC recurrence. Conclusions The prophylactic intravesical chemotherapy is a useful approach for reducing the recurrence of bladder TCC after surgery of upper urinary tract TCC. A possible reduction of bladder TCC-risk by intraoperative ureteric ligation and/or peri - operative topical intravesical chemotherapy instillation are justified.
出处
《国际泌尿系统杂志》
2009年第3期300-303,共4页
International Journal of Urology and Nephrology
关键词
肾肿瘤
输尿管肿瘤
膀胱肿瘤
Kidney Neoplasms
Ureteral Ueopasms
Bladder Neoplasms
