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題名 | Ureteroscopic Diagnosis and Management of Upper Urinary Tract Neoplasm--Clinical Experience in Veterans General Hospital-Taipei=以輸尿管鏡診斷及治療上泌尿道腫瘤--臺北榮民總醫院之臨床經驗 |
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作者 | 洪敦智; 郭俊逸; 陳光國; 張心湜; | 書刊名 | 中華民國泌尿科醫學會雜誌 |
卷期 | 9:3 1998.09[民87.09] |
頁次 | 頁154-158 |
分類號 | 416.27 |
關鍵詞 | 上泌尿道; 移形上皮癌; 輸尿管鏡; 雷射; Upper urinary tract; Transitional cell carcinoma; Ureteroscopy; Laser coagulation; |
語文 | 英文(English) |
中文摘要 | 隨著數十年來泌尿道內視鏡技術的進步,使我們在診斷及治療上泌尿道腫瘤上有 很大的進展。本篇提出台北榮民總醫院以輸尿管鏡技術診治上泌尿道移形上皮癌的經驗。 45位靜脈腎盂攝影或逆行性腎盂攝影有不正常顯影的病人均接受輸尿管鏡的檢查,其 中33位證實為移形上皮癌(腎盂:13,輸尿管:20),其餘12位則為非種瘤性病灶。而這 33位病人中有7位接受保守性的雷射治療(腎盂:4,輸尿管:3),且合併管腔內化學藥物 的灌注。至於手術併發症則很少。在平均9.9個月的追蹤中,有6位病患因復發需再次的內 視鏡方式治療。 以輸尿管鏡技術診治上泌尿道移形上皮癌是很安全且有效的方法,但因復發率高,密集 的追蹤更有其必要性。 |
英文摘要 | Advances in endourologic techniques during the past decade have led to new concepts in the diagnosis and treatment of upper urinary tract (UUT) lesions. We retrospectively review our experiences in the diagnosis and management of upper urinary tract transitional cell carcinoma with ureteroscopic technique. From Jan. 1995 to Dec. 1997, ureteroscopy was performaed in 45 patients for upper urinary tract filling defects. Of these patients, 33 were found to have urothelial tumors and the remaining 12 had non-tumorous lesions, including stones, blood clots, and essentially unremarkable disease. Of 33 p atients with urothelial tumors, 7 (21%) received conservative treatment with Nd-YAG laser photocoagulation. Mean follow-up time was 9.9 mo. And 6 of 7 (85.7%) cuses experienced tumor recurrence. These patients all received repeated endoscopic treatemt. Three of them had at least 2 rcurrences, and 2 patients finally died of metastatic diseases: 1 had lung metastasis and the other had liver metastasis. Complications in other patients were minimal. In conclusion, ureteroscopic diagnosis and treatment of transitional cell carcinoma of the upper urinary tract can be performed in selected cases with minimal morbidity and a satisfactory success rate. However, close follow-up for recurrence should be conducted for patients receiving such treatment. |
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