Percutaneous Kidney-sparing Surgery for Upper Tract Urothelial Carcinoma:Report of 11 Cases
Objective To analyze the clinical efficacy of percutaneous kidney-sparing surgery(PCKSS)for the treatment of upper tract urothelial carcinoma(UTUC).Methods A retrospective analysis was conducted on clinical data and oncological characteristics of 11 cases of UTUC treated with PCKSS at our hospital from January 2018 to December 2023.After establishing a percutaneous renal working channel,a laser fiber or plasma resection device was inserted through the nephroscope to remove the tumor piece by piece along the edge of the tumor by 0.5 cm.Results All the 11 cases of PCKSS surgery were successfully completed,with 3 cases having multiple tumors.The surgical time was 75-216 min(median,150 min),and the intraoperative bleeding volume was 20-400 ml(median,150 ml).Postoperative pathological diagnosis showed 9 cases of high-grade UTUC,including 3 cases of G2 grade and 6 cases of G3 grade,with 5 cases in pTa phase and 4 cases in pT1 phase.In 2 cases with preoperative ureteroscopic biopsy showing high-grade pTa phase UTUC,no definite tumor was found during the PCKSS due to shallow sampling and obvious tissue burning.The average postoperative hospitalization time was(6.9±2.6)d.The 1 1 cases were followed up for 2-55 months(median,12 months),and there were 4 cases of recurrence,including 2 deaths,and 7 cases of recurrence free survival.Conclusions PCKSS has certain application value for treating UTUC with renal insufficiency.However,it is necessary to carefully select suitable patients before surgery,and strict and regular follow-up is required after surgery.
万方数据
维普
