上管尿路癌的节能手术 - 方式,结果和限制
1Department of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
Journal of clinical medicine
|November 9, 2024
概括
节性手术为低风险的上路泌尿道癌 (UTUC) 提供了激进脏切除术的替代方案. 对于有利的低度UTUC,建议进行内镜激光切除,尽管复发和进展仍然令人担忧.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
背景情况:
- 上道泌尿道癌 (UTUC) 占泌尿道癌的5-10%,发病率和显著的发病率/死亡率不断增加.
- 激进脏切除术 (RNU) 是高风险UTUC的标准,但其高发病率激发了对低风险病例节省替代品的兴趣.
研究的目的:
- 审查UTUC治疗中节能疗法的技术变化和证据.
- 评估UTUC的各种脏节约手术方法的实用性和结果.
主要方法:
- 对UTUC的节能手术技术的当前文献的综述.
- 分析与不同节约方式相关的结果,不良事件和限制.
- 对某些UTUC病例的节约方法与传统的RNU进行比较.
主要成果:
- 节性手术的选择包括细分泌尿切除术,内镜切除术,化疗切除术和血管向光疗.
- 建议对有利的低度UTUC进行内镜激光切除与可选的辅助性腔内治疗.
- 副作用包括尿管狭窄,出血和膀复发;限制涉及低分级/阶段和更高的复发率.
结论:
- 节手术是低风险UTUC的可行选择,在某些情况下提供与RNU相似的结果.
- 仔细选择患者并考虑潜在的限制对于成功的节约性UTUC管理至关重要.
- 内镜激光切除是有利于低度UTUC的首选方法,平衡有效性与器官保存.
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