Prise en charge endoscopique des tumeurs urothéliales du haut appareil urinaire

摘要: OBJECTIVE The reference treatment for filling defects of the upper urinary tract is nephroureterectomy with excision a perimeatal bladder segment. authors evaluated role endoscopy and laser in management tract. MATERIAL AND METHODS Filling were by biopsies performed during ureteroscopy followed 10 Watt Holmium-YAG vaporisation. High-grade or incompletely vaporised tumours multifocal more than 2 cm diameter received complementary treatment. Low-grade completely at 3 months then every 6 months. conducted prospective study from March 2002 to September 2004. Fifteen consecutive patients managed according this protocol. mean age was 70 years (range: 53 85 years). Thirty nine treated. tumour 1.05 0.3 2.5 cm). RESULTS In series 15 treated protocol, 39 diagnosed grade determined biopsy 66% cases. Seven have median recurrence-free survival 18 12 34 months). Overall, conservative able be twelve patients, corresponding 22-month kidney preservation rate 80%. Two died follow-up, one prostatic cancer other invasive urothelial tumour. One patient who had recurrence ans been re-treated lost report. CONCLUSION can investigated obtain histological diagnosis perform Complementary depending on results, either vaporisation nephroureterectomy. Laser ensures high but risk. Conservative endoscopic treatment, which considered acceptable cases necessity, may also useful context small, unifocal, minimally normal contralateral kidney.