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Diagnosis and treatment of transitional cell carcinoma of kidney recipients following renal transplantation

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
Issue:
1
DOI:
10.3760/cma.j.issn.0254-1785.2006.01.004
Key Word:
肾移植;泌尿系肿瘤;癌,移行细胞

Abstract: 目的总结肾移植后并发自体泌尿系统移行细胞癌的诊治体会.方法9例患者在肾移植术后11~48个月出现间歇性血尿,通过B型超声波、静脉尿路造影(IVU)、膀胱镜、输尿管镜、逆行肾盂造影、CT及内窥镜下取材活检等,证实3例为肾盂肿瘤,2例为输尿管肿瘤,4例为膀胱肿瘤.肾盂肿瘤和输尿管肿瘤的5例均采取肾、输尿管全程及膀胱部分切除术;4例膀胱肿瘤患者中,3例行经尿道膀胱肿瘤电切术,1例施行膀胱全切及移植肾切除术.有2例患者因肿瘤复发或新发而接受了2次肿瘤切除术.术后通过膀胱灌注给予丝裂霉素、吡柔比星、表阿霉素等进行化疗.结果9例患者11次手术均顺利,治疗效果比较满意,在施行肿瘤切除术前后不需调整免疫抑制治疗方案.结论对肾移植后并发自体泌尿系统移行细胞癌的患者,关键在于早期诊断、积极治疗,应慎重对待肾移植后出现血尿的患者,以免漏诊.

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