| Objective:Retrospectively analyzing the clinical data of patients with renal pelvic cancer in our hospital from 2009 to 2013,to To improve the clinical diagnosis,treatment and prognosis of renal pelvis cancer in our hospital.Materials and Methods:This study retrospectively analyzed the clinical data of 52 cases of renal pelvic cancer who had undergone surgical treatment and were pathologically diagnosed in our hospital from February 2009 to January 2013,and were followed up.Paraments examined include clinical manifestations,diagnosis,postoperative pathological character,operative access and prognosis.Results:Of the 52 patients,32 cases(62%,32/52)were males and 20(38%,20/52)females,with an average age of 66.9 years(50~92 year),21 cases of 60-70 years(40%),and 14 cases of 70~80 years(27%),and 5 cases(10%)of over 80 years old.The first symptom of most patients were painless gross hematuria(39,72%),with a duration of 3 days to 2 years.Besides,there are 7 cases with back pain,1 case with fever,4 cases with physical imaging findings,and 1 case with microscopic hematuria as the first symptom.Among the cases included,45 patients had urine exfoliated cytology and 15 were positive(33%).50 cases of urological color Doppler ultrasound examination,which prompted the pelvis at the tumor or tumor location and other positive findings in 39 cases,suggested that renal cell carcinoma in 3 cases,suggested that stones in 4 cases.30 patients underwent IVU examination,including 12 positive cases.49 cases of patients with CT / CTU examination,suggested that the pelvis at 46 cases and 3 cases of renal cell carcinoma.52 cases were treated by surgery,anesthesia were general anesthesia.20 cases were received radical nephroureterectomy and sleeve resection of the bladder;28 cases received laparoscopic nephroureterectomy and sleeve resection of the bladder;2 patients received nephron-sparing surgery for renal pelvis cancer.After radical ureterectomy,2 patients were treated with transurethral treatment of the distal end of the ureter and the surrounding bladder mucosa.Postoperative pathology showed 50 cases of transitional cell carcinoma and 2 cases of squamous cell carcinoma.According WHO grade: low-level 10 cases,high-level 42 cases.TNM clinical stage: T1 18 cases,T2 13 cases,T3 20 cases,T4 1 case.52 patients were followed up.The follow-up rate was 100% and an average follow-up time was 43 months,ranged from 11~71 months.The three-year and five-year survival rates were 87.1%(27/31)and 64.5%(20/31)respectively in patients with stage T1~2.The three-year and five-year survival rates of stage T3~4 patients were 28.6%(6/21)),14.3%(3/21).Conclusions:Gross hematuria is the most common clinical manifestation of renal pelvis malignancy.Urine cytology is a commonly used method for the diagnosis of upper urinary tract tumors.The urinary B ultrasound is the primary screening method for urinary system tumors.It has the advantages of simple operation,real-time,dynamic,inexpensive,and wide application.In recent years,imaging techniques such as computer and CT examinations have greatly improved,and MDCTU has been the most commonly used imaging examination method for diagnosing renal pelvis cancer.RNU+ bladder sleeve ligation is still the standard method for eradicating malignant tumors of the renal pelvis.The choice of open surgery or laparoscopic surgery needs to be combined with the operator's operating experience as well as the patient's preoperative general condition,tumor stage,and size.However,the choice of what options to treat residual ureters and bladders still requires more clinical research.The staging and grading of renal pelvic malignant tumors are important factors affecting the outcome of patients.To sum up,in order to improve the survival rate and quality of life of patients with renal pelvis cancer,we should strengthen the knowledge of relevant diseases in daily work,pay attention to the early detection and early diagnosis of renal pelvic malignant tumors,timely surgery,and strengthen postoperative follow-up. |
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