本文選題：經(jīng)尿道雙極等離子電切術(shù)　切入點(diǎn)：移行細(xì)胞癌　出處：《中國(guó)微創(chuàng)外科雜志》2016年04期

【摘要】：目的探討經(jīng)尿道雙極等離子電切治療腎移植后膀胱腫瘤的療效和安全性,評(píng)價(jià)術(shù)后腫瘤復(fù)發(fā)的危險(xiǎn)因素。方法 2009年9月~2014年6月采用經(jīng)尿道雙極等離子電切術(shù)治療腎移植術(shù)后膀胱腫瘤16例,術(shù)中汽化切割腫瘤直達(dá)深肌層,術(shù)后定期膀胱灌注化療。術(shù)后患者定期隨訪,觀察腫瘤復(fù)發(fā)情況。采用Cox比例風(fēng)險(xiǎn)回歸模型分析影響腫瘤復(fù)發(fā)的危險(xiǎn)因素。結(jié)果 16例均成功完成經(jīng)尿道雙極等離子電切術(shù),平均手術(shù)時(shí)間34.1 min(15~60 min)。術(shù)后隨訪時(shí)間14~62個(gè)月,中位隨訪時(shí)間45個(gè)月,腫瘤復(fù)發(fā)率50.0%(8/16),其中87.5%(7/8)術(shù)后2年內(nèi)復(fù)發(fā)。多因素分析表明,原腎馬兜鈴酸腎病(HR=7.040,95%CI:1.411~35.121,P=0.017)與腫瘤直徑≥3 cm(HR=8.230,95%CI:1.055~59.834,P=0.046)是術(shù)后復(fù)發(fā)的危險(xiǎn)因素。結(jié)論經(jīng)尿道雙極等離子電切術(shù)是治療腎移植術(shù)后非肌層浸潤(rùn)膀胱腫瘤的有效方法,切除效率高,安全性較好。術(shù)后仍有較高的復(fù)發(fā)率,大多數(shù)病例術(shù)后2年內(nèi)復(fù)發(fā),原腎馬兜鈴酸腎病、腫瘤直徑≥3 cm的患者,術(shù)后復(fù)發(fā)風(fēng)險(xiǎn)較高。
[Abstract]:Objective to evaluate the efficacy and safety of transurethral bipolar plasma resection in the treatment of bladder tumor after renal transplantation. Methods from September 2009 to June 2014, 16 cases of bladder tumor after renal transplantation were treated by transurethral bipolar plasma resection. The patients were followed up regularly to observe the recurrence of tumor. Cox proportional risk regression model was used to analyze the risk factors of tumor recurrence. Results all the 16 patients underwent transurethral bipolar plasma resection successfully. The mean operative time was 34.1 min(15~60. The mean follow-up time was 14 ~ 62 months, and the median follow-up time was 45 months. The recurrence rate of tumor was 50.0% / 16%, 87.5% / 8% of which recurred within 2 years after operation. Proto-aristolochic acid nephropathy (HRN) 7.040C95CI1.411115121P0.017) and the diameter of tumor 鈮，

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