Surgical Diagnosis And Treatment Of Renal Pelvic Cancer (with 50 Cases Report)

Objective:Retrospectively analyzed the 5-year clinical data in patients of renal pelvic cancer, with the experience of Urology Department of Shandong Provincial Hospital, to evaluate the surgical diagnosis and treatment of renal pelvic carcinoma.Materials and Methods:The retrospective study included clinical data of a total of 50 patients received surgical treatment and diagnosed as renal pelvic carcinoma postoperatively, from November 2008 to November 2013. Statistics in all cases related to preoperative, intraoperative, and postoperative data were be performed and statistical analysis was used to assess the surgical diagnosis and surgical treatment of renal pelvic cancer.Results:Of the 50 patients included, there are 29 cases (58%) in men and 21 (42%) in women, with an average age of 65.9 year (43-84 year),14 cases of 70-80 year (28%), and 4 cases (8%) of over 80 year. The most common symptoms are painless gross hematuria (38,76%), with a duration of 4 days to 8 years. Besides, there are 6 cases of back pain,1 case of fever,1 case of weight loss,3 cases of checking imaging findings,1 case of microscopic hematuria as the first symptom. Tumor size on image shown 1.0* 0.6～6.3* 3.8cm. All surgical procedures are smooth,3 cases of endoscopic surgery turn to the open surgery in the midway, and there were no significant complications between intraoperative and postoperative condition.25 cases patients were received radical nephroureterectomy and sleeve resection of the bladder; 10 cases received laparoscopic nephroureterectomy and sleeve resection of the bladder; 8 cases received palliative treatment only resecting the lateral kidney; 2 cases received nephron-sparing surgery for renal pelvic cancer.9 cases were given intraoperative transfusion, the average blood transfusion was 333.3 ml. There was an average time of 182.0 min in surgeries. Mean postoperative hospital stay is 9.24 D. All procedures were completed successfully. None of the cases experienced conversion to open surgery or vascular complications.Conclusion:Painless gross hematuria is the most common symptom of renal pelvis carcinoma. Enhanced CT urography (MDCTU) become the recommended auxiliary examination to understand the situation of upper urinary tract instead. Radical nephroureterectomy and sleeve resection of the bladder is still the classic surgical operation for renal pelvis cancer, a variety of new technologies for distal ureteral resection requires to be further evaluated.