Трансуретральная резекция карциномы мочевого пузыря, распространяющейся на устье мочеточника

Уротелиальный рак в 90-95 % случаев первично поражает мочевой пузырь и только у 5-49 % пациентов находится вблизи устья мочеточника или полностью закрывает его. Метахронный уротелиальный рак верхних мочевыводящих путей возникает, как правило, через 3 и более года после трансуретральной резекции первичной опухоли мочевого пузыря или радикальной цистэктомии, а его частота при вовлечении устья мочеточника колеблется от 0 до 20 %, по некоторым данным достигая 51 %. В настоящее время нет четких рекомендаций и лечебно-диагностического алгоритма по ведению этой категории больных. В статье приведены эпидемиологические данные, рассмотрены возможные причины и факторы риска развития рецидивов уротелиального рака верхних мочевыводящих путей, описаны показания к органосохраняющему лечению, особенности хирургической техники при трансуретральной резекции опухоли устья мочеточника, возникающие осложнения и методы их профилактики.

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