Clinical Analysis Of Three Kinds Of Laparoscopic Assisted Treatment Of Upper Urinary Tract Urothelial Carcinoma

Objective:To compare the laparoscopic nephrouretereetomy combined ureteral inversion,laparoscopic nephroureterectomy combined transurethral ureterotomy,and laparoscopic nephroureterectomy combined open bladder cuff excision for the treatment of upper tract urothelial carcinoma with radical surgery.Materials and Method:Retrospective analysis of seventy cases with upper urinary tract urothelial carcinoma treated by laparoscopic surgery at Yanbian University Hospital from January 2012 to January 2018.Twenty cases of whom underwent laparoscopic nephroureterectomy combined ureteral inversion(Group A),twenty cases underwent laparoscopic nephroureterectomy combined transurethral ureterotomy(Group B),and thirty cases underwent laparoscopic nephroureterectomy combined open bladder cuff excision(Group C).The age,gender,side,tumor location,tumor diameter,stage,differentiation,operation time,intraoperative blood loss,indwelling catheterization time,complications,postoperative tumor recurrence rate,etc.were used statistical analysis.Three groups of patients were given regular intravesical chemotherapy and were followed up for six to twelve months.Results:There were no statistically significant differences in age,gender,side,tumor location,tumor diameter,stage,and differentiation between the three groups(P>0.05).There were no significant differences in postoperative intravesical tumor recurrence rate,extra-bladder tumor recurrence rate,postoperative complications(P>0.05).There was no significant difference in the amount of bleeding between the three different treatments(P>0.05).The operation time of the group B(171.5±38.8)was longer than the group A(136.3±36.6)(P=0.001),and the operation time of the group C(179.8±45.2)was longer than that group A(P<0.05),but the group B was no significant difference between the group C(P>0.05).The indwelling catheterization time of the group C(M(Q1,Q3):8.0(7.0,8.3))was significantly lower than the group A(M(Q1,Q3):11.0(10.0,13.3)),and significantly lower than the group B(M(Q1,Q3);10.0(9.0,12.0))(P<0.001),but the group A compared with the group B,then There was no significant difference(P>0,05).Conclusion:By analyzing the three groups of clinical observation indicators,the surgical effects of the three methods of treating the lower end of the ureter are similar.Compared with the other two surgical methods,laparoscopic assisted open bladder cuff excision has obvious advantages in shortening the time of postoperative indwelling catheter,which can improve the quality of life of patients.