上泌尿道移行上皮癌之標準術式一直是腎臟輸尿管連同膀胱接口一併切除。我們回顧本院這類病人採用保守性手術之情形。回顧1992年6月至1997年12月於本院診斷為上泌尿道移行上皮癌的病人共有198位，其中7位接受保守性手術予以研究。這七位病人（三位男性四位女性），平均年齡60歲。腫瘤位於輸尿管（6位）及腎盂（1位）。保守性手術包括手術中內視鏡腫瘤切除術，腫瘤切除合併輸尿管重接術，及輸尿管鏡腫瘤切除術。採用保守性手術的適應症大多因為只剩單一腎臟。平均追蹤時問為16.6個月。大多數病人預後良好。有2位續發膀胱腫瘤，一位末期癌症病人術後11個月死亡。保守性手術可選擇性地應用於某些上泌尿道移行上皮癌的病人，唯X光影像學及膀胱鏡的長期追蹤檢查是必要的。

Nephroureterectomy including bladder cuff en bloc has been considered the standard operation for upper urinary tract transitional cell carcinoma (TCC). We reviewed the conservative surgery of these cases in our institute. Patients diagnosed with upper urinary tract TCC between June 1992 and December 1997 in our hospital were reviewed. Seven patients out of 198 cases of upper urinary tract TCC who received conservative surgery entered this study. The mean age of the 7 patients (3 men and 4 women) was 60 years. The tumors were located in the ureters (6 cases) and renal pelvis (1 case). The conservative surgery performed included intraoperative resectoscopic resection of the tumor, open resection of the tumor with primary anastomosis of the ureters, and/or ureteroscopic resection of the tumor. Indications for these conservative surgeries were mostly solitary kidney. The mean follow-up period was 16.6 months. The outcome of most patients was fair. Bladder tumors developed in 2 cases and one patient in the terminal stage died 11 months after surgery. Conservative surgeries are recommended in selected cases of upper urinary tract TCC. But long-term radiographic follow-up of the upper urinary tract and endoscopic surveillance of the bladder is mandatory.