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Preventing strategies of bladder cancer recurrence after surgery for upper tract urothelial carcinoma
Author(s): KONG Chui-ze, LIU Ben, LI Zhen-hua, YANG Shao-bo, SUN Zhi-xi
Pages: 250-
252
Year: 2006
Issue:
4
Journal: CHINESE JOURNAL OF UROLOGY
Keyword: 肾盂; 输尿管; 移行细胞癌; 膀胱肿瘤;
Abstract: 目的探讨预防肾盂输尿管癌术后再发膀胱癌的手术方法.方法对156例单纯肾盂癌、单纯输尿管癌中获随访的139例患者资料进行回顾性总结.肾盂癌78例,输尿管癌61例.肿瘤细胞分级:G119例,G2 88例,G3 32例.肿瘤分期:Ta~T1 38例,T2 80例,T3~T4 21例.肿瘤直径0.8~6.0 cm.结果139例均行根治性肾、输尿管及管口周围部分膀胱壁(1.5~2.0 cm)切除术.术后随访1~10年,再发膀胱癌55例,占39.6%.肾盂癌术中先用纱条结扎输尿管后游离切除患肾输尿管及管口周围部分膀胱者术后膀胱癌再发率18.5%(5/27),未先结扎输尿管者再发率27.5%(14/51).术后当日膀胱灌注化疗者膀胱癌再发率32.3%(10/31),术后3周开始膀胱灌注化疗者膀胱癌再发率34.9%(30/86).术后当日及术后序贯膀胱灌注化疗者术后膀胱癌再发率20.0%(4/20),单纯术后序贯膀胱灌注化疗者膀胱癌再发率39.3%(26/66),2者比较差异有统计学意义(P<0.01).结论术后当日及术后序贯膀胱灌注化疗可有效降低肾盂输尿管癌术后膀胱癌的再发率,游离切除肾输尿管前先结扎输尿管对预防肾盂癌术后再发膀胱癌可能有益.
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