[What is the role of endoscopy in the diagnosis and treatment of tumors of the upper urinary tract?].
17 patients with upper urinary tract tumours were investigated by endoscopy. 3 patients (Group I) with fibrous or fibroepithelial polyps were treated via a retrograde approach and did not develop any recurrences. 2 patients (Group II) developed unexplained haematuria: the diagnosis of high-grade carcinoma was confirmed by endoscopy and they were treated by nephroureterectomy. 12 patients (Group III) with low grade non-invasive urothelial carcinoma, in whom radical surgical was not indicated, were treated conservatively via the percutaneous (13 tumours) or retrograde (1 tumour) endoscopic approach. The local recurrence rate was 33% (4 out of 12 tumours) for a mean follow-up of 22 months. The recurrences were treated by repeated endoscopy in 3 patients, and by nephroureterectomy in 1 patient. Endoscopic treatment of upper urinary tract tumours should be reserved for benign tumours and selected cases of low-grade, non-invasive urothelial carcinoma.
Gelet
A
A
Service d'Urologie et Chirurgie de la Transplantation, hôpital Edouard Herriot, Lyon.
Ballanger
P
P
Abbar
M
M
Viguier
J L
JL
Marechal
J M
JM
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D003558:Cystoscopy / Q000379:methods / Q000592:standards*; D004598:Electrosurgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008028:Light Coagulation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D012086:Reoperation; D014567:Urography; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy
Quelle doit être la place de l'endoscopie dans le diagnostic et le traitement des tumeurs de la voie excrétrice du haut appareil?