英文摘要 |
To review the clinical outcomes of upper urinary TCC patients treated in our hospital during the past 10 years. Between 1995 and 2005, 102 patients were diagnosed as having upper urinary tract TCC in Show Chwan Memorial Hospital. The gender, age, place of residence, clinical signs and symptoms of all patients were recorded. 59 patients received surgical treatment, including nephroureterectomy with bladder cuff excision, antegrade or retrograde endoscopic ablation or segmental ureterectomy. Furthermore, detailed data regarding the gender ratio and clinical presentation of these patients were collected and analyzed.In our study, bladder cuff excision methods during nephroureterectomy included open surgery and the “pluck” technique (transurethral resection of bladder cuff). Differences between techniques in regard to complications and oncological outcome were not significant. 6 patients received the nephron-sparing approach. Advancements in endourology have made it possible to treat upper urinary TCC conservatively in selected patients. On the other hand, the male to female ratio was found to be 1:1.77, showing a female predominance in our study. The ratio of TCC of the renal pelvis to TCC of the ureter to TCC of the bladder was approximately 1:0.9:10. TCC of the renal pelvis accounted for 15% of all urothelial TCC, and for approximately 60% of all renal carcinoma. It is interesting to compare our clinical appearance to the up-to-date database. The clinical picture in our series completely differed from other literature.For management the distal ureter in nephrouretectomy, both open and pluck techniques proved oncologically safe. Nephron-sparing technique is now a feasible alterative to nephrouretectomy in selected patients. The gender incidence and ratio of renal pelvis TCC to all renal carcinomas are different in Mid-Taiwan with data presented in the up-to-date database. Further study for proving this point should be performed. |