题名

以腎臟保留手術治療上泌尿道尿路上皮細胞癌的現況

DOI

10.6666/ClinMed.201809_82(3).0096

作者

林子平

关键词

泌尿上皮細胞癌(upper urinary tract urothelial cancer) ； 腎臟保留手術(kidney sparing surgery) ； 雷射氣化(laser ablation)

期刊名称

臨床醫學月刊

卷期/出版年月

82卷3期（2018 / 09 / 28）

页次

534 - 537

内容语文

繁體中文
中文摘要

上泌尿道尿路上皮細胞癌(UTUC) 往往在初診斷的時候就呈現相當侵犯性的特色，使得對大部分上泌尿道尿路上皮細胞癌的患者而言，根除性腎輸尿管及膀胱袖口切除術仍然是標準的治療。對比於標準手術之外腎臟保留手術可以做為替代治療，近年來由於輸尿管切除術以及內視鏡腫瘤雷射切除(laser ablation)所達到的良好癌症控制成績鼓勵了泌尿腫瘤醫師將適應症放寬到對側功能也正常的選擇性適應症(elective indication)。患側腎臟沒有水腎，輸尿管鏡切片的病理診斷是低度惡性，且小便細胞學是陰性。是選擇病人接受腎臟保留手術最嚴格的條件。腎臟保留手術在內視鏡腫瘤切除之後並沒有結束，腫瘤治療成績仰賴病人與治療醫師配合接受密切的上泌尿道內視鏡以及膀胱鏡的追蹤，所以病人的配合度是相當重要的。總結來說，在泌尿科內視鏡以及成像系統的快速進展之後，腎臟保留手術的適應症也較過去放寬許多，針對選擇性適應症的癌症病患治療成功與否，適當的病人選擇是最重要的。我們應該對於各種手術方式的優點、缺點以及各種治療方式的限制有通盤的了解，才能給予病人最適當的諮詢來選擇最適當的治療方式。
主题分类 醫藥衛生 > 基礎醫學
醫藥衛生 > 社會醫學
参考文献
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