Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press143410.17650/1726-9776-2021-17-2-104-111DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. URINARY BLADDER CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак мочевого пузыряTransurethral resection of bladder cancer involving the orifice of the ureterТрансуретральная резекция карциномы мочевого пузыря, распространяющейся на устье мочеточникаNovikovA. I.НовиковА. И.
Russian Federation

Andrey I. Novikov.

68а Leningradskaya St., Pesochny Settl., Saint-Petersburg 197758.

Новиков Андрей Иванович.

197758 Санкт-Петербург, пос. Песочный, Ленинградская ул., 68а.

novikov_urol@mail.ruhttps://orcid.org/0000-0001-9710-2406LeonenkovR. V.ЛеоненковР. В.
Russian Federation

68а Leningradskaya St., Pesochny Settl., Saint-Petersburg 197758.

Леоненков Роман Викторович.

197758 Санкт-Петербург, пос. Песочный, Ленинградская ул., 68а.

SPIN-код: 6603-4090

rovile@bk.ruTemkinD. B.ТемкинД. Б.
Russian Federation

6 Akademika Pavlova St., Murmansk 183032.

183032 Мурманск, ул. Академика Павлова, 6.

BorovikM. V.БоровикМ. В.
Russian Federation

6 Akademika Pavlova St., Murmansk 183032.

183032 Мурманск, ул. Академика Павлова, 6.

ShpilenyaE. S.ШпиленяЕ. С.
Russian Federation

41 Kirochnaya St., Saint-Petersburg 191015.

191015 Санкт-Петербург, ул. Кирочная, 41.

AlferovaN. V.АлфероваН. В.
Russian Federation

41 Kirochnaya St., Saint-Petersburg 191015.

191015 Санкт-Петербург, ул. Кирочная, 41.

Saint-Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (oncological)Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический)P.A. Bayandin Murmansk Regional Clinical HospitalМурманская областная клиническая больница им. П.А. БаяндинаI.I. Mechnikov North-Western State Medical University, Ministry of Health of RussiaСеверо-Западный государственный медицинский университет им. И.И. Мечникова Минздрава России250720211721041110204202129062021https://oncourology.abvpress.ru/oncur/article/view/1434

In 90-95 % of cases, urothelial cancer primarily affects the bladder and in about 5-49 % of patients it can be located near or completely close the orifice of the ureter. Metachronous urothelial cancer of the upper urinary tract occurs, as a rule, 3 or more years after transurethral resection of the primary bladder tumor or radical cystectomy, and its frequency with involvement of the ureteral orifice ranges from 0 to 20 %, reaching 51 %. Currently, there are no clear recommendations and diagnostic and treatment algorithm for the management of this category of patients. This review examines the frequency, possible causes and risk factors for recurrence of upper urinary tract tumors, indications for organ-preserving treatment, features of surgical technique for transurethral resection of ureteral orifice tumors, emerging complications and methods of their prevention.

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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