输尿管肾切除术

Laparoscope combined with cystoscope for the treatment of upper tract transitional cell carcinoma is safe and effective.

对肾盂癌和中、上段输尿管癌采取腹腔镜联合膀胱镜行肾、输尿管全长切除可闭合输尿管末端，避免术中肿瘤种植，是一种安全有效的手术方式。

Methods Three hundred and fifty patients for laparoscopic surgery were admitted to our department from August 2001 to February 2002. They included 45 cases of adrenal glands surgery, 55 simple nephrectomy, 25 radical nephrectomy, 11 nephroureterectomy, 3 partial nephrectomy, 110 renal cyst decortication, 4 polycystic kidney decortication, 12 ureterolithotomy, 16 pyeloplasty, 3 retrocaval ureteroplasty, 58 varicocele-varix ligation and 8 pelvic lymph node dissection.

从2001年8月～2004年2月，350例患者施行了腹腔镜下泌尿外科手术，其中肾上腺手术45例，单纯肾切除55例，根治性肾切除25例，肾输尿管全切11例，肾部分切除3例，肾囊肿去顶术110例，多囊肾去顶减压术4例，输尿管切开取石术12例，UPJ成型术16例，腔静脉后输尿管成型术3例，精索静脉高位结扎术58例，盆腔淋巴结切除术8例。

Methods The data of 16 cases of ureteral polyps were reviewed and discussed. 2 cases were treated with nephroureterectomy; 10 cases with local resection plus pyeloplasty or ureteral reimplantation; 4 cases with polyps resection plus basement fulguration.

回顾分析16例原发性输尿管息肉患者的临床资料，其中2例行肾输尿管大部切除术，10例行病变输尿管切除加肾盂成形术或输尿管再植术，4例行息肉切除加基底电灼术。

Rusults In 11 cases, 1 case was underwent nephroureterectomy, 3 cases local resection plus pyeloplasty, 1 case local resection plus ureteroureterostomy, 4 cases polyps resection plus basement fulguration, 2 cases polypous basement resection under ureteroscopy.

结果 11例患者中，1例行肾与输尿管大部切除，3例行输尿管病变段切除肾盂成形术，1例病变段切除输尿管再吻合术，4例行息肉切除加基底电灼，2例输尿管镜下基底部钳除。

Results Irritative symptoms (78%) and gross hematuria (36%) were the most common symptoms encountered in these patients.

结果尿路刺激症状和血尿为最常见症状，分别为78％和36％。24小时尿抗酸杆菌和尿结核PCR的阳性率分别为25％和40％，IVU，逆行尿路造影及CT的诊断符合率分别为38％，63％和44％。33例患者接受了肾及部分输尿管切除术，肾上盏结核病灶清除术1例，对侧输尿管膀胱吻合术1例及肾穿刺造瘘术1例。1例患者并发血行播散型结核死亡。

Results Irritative symptoms (78%) and gross hematuria (36%) were the most common symptoms encountered in these patients.Acid-fast stains on urinary sediment were positive in 25% of cases and TB-PCR was positive in 40%.The diagnostic accuracy of IVU,retrograde urography and CT in these patients were 38%,63% and 44% respectively.33 patients underwent a nephrectomy and partial ureterectomy,one of them had a contralateral ureter reimplantation.One patients died of miliary tuberculosis. Conclusions Acid-fast stain remains a major pathogen-detecting tool and the value of TB-PCR needs to be confirmed.

结果 尿路刺激症状和血尿为最常见症状，分别为78%和36％。24小时尿抗酸杆菌和尿结核 PCR 的阳性率分别为25％和40％， IVU ，逆行尿路造影及 CT 的诊断符合率分别为38%，63%和44%。33例患者接受了肾及部分输尿管切除术，肾上盏结核病灶清除术1例，对侧输尿管膀胱吻合术1例及肾穿刺造瘘术1例。1例患者并发血行播散型结核死亡。

There were no blood transfusion or serious complication in the study.Conclusions:Retroperitoneal laparoscopic operation,such as adrenalectomy,nephropexy,pelvioplasty,unroofing of renal cyst,pelvilithotomy,ureterdithotomy and spermatic vein ligation,have the advantages of minimai invasion,less blood loss and fewer complications,which is an effective and practical procedure.

后腹腔镜肾上腺瘤切除术、肾固定术、肾盂成形术、肾囊肿去顶术、肾盂或输尿管切开取石术及腹腔镜精索静脉高位结扎术具有创伤小、出血少、并发症少等优点，临床疗效可靠，实用性较强。

Ultrasonographymay be preliminary diagnostic method for ureteral carcinoma because it can showhydronephrosis,retrograde ureteropyelography and CT scanning were main diagnostic measures before operation.

残余段输尿管+膀胱部分切除术2例。结论 B超发现肾积水可作为初步筛选检查，逆行输尿管插管造影、CT是术前诊断输尿管癌的重要手段。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。