整块剜除术治疗非肌层浸润性膀胱肿瘤

230022合肥市,安徽医科大学第一附属医院泌尿外科

膀胱肿瘤;整块剜除术;绿激光;水刀;经尿道手术

En bloc enucleation for the treatment of non-muscle invasive bladder tumors
Zhang Yifei, Liang Chaozhao, Shi Haoqiang, Hao Zongyao, Zhou Jun,Fan Song, Jiang Changqin, Tai Sheng, Yang cheng.

Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China

Bladder tumor; En bloc enucleation; Green laser; Water-jet; Transurethral operation

DOI: 10.3877/cma.j.issn.1674-3253.2016.06.003

备注

目的 探讨整块剜除术治疗非肌层浸润性膀胱肿瘤的疗效及手术技巧。方法 回顾性分析 2013年 2月至 2015年 6月,安徽医科大学第一附属医院收治的 34例患者,采用直出绿激光及水刀行整块剜除术治疗膀胱肿瘤。观察手术时间、出血量及术后并发症等指标来评估手术的安全性及治疗效果。结果 所有手术均成功完整剜除肿瘤,手术时间平均 13 min。术中出血少,无膀胱穿孔,无闭孔神经反射,无膀胱穿孔等严重并发症。术后膀胱冲洗 2~6 h,导尿管保留 48 h,随访 3个月至 1年,肿瘤无复发。结论 整块剜除术治疗非肌层浸润性膀胱肿瘤有手术时间短,出血少,并发症少的特点,并能保持肿瘤形态完整,有利于精确的病理学分期分级,是一种安全有效的治疗方式。
Objective To investigate the clinical effect and to improve operation skill of en bloc enucleation in treating non-muscle invasive bladder tumors. Methods Thirty-four patients with bladder tumor were selected in the First Affiliated Hospital of Anhui Medical University, from February 2013 to June 2015, en bloc enucleation was performed for the treatment of the bladder tumor by straight light greenlight laser or water-jet. The data of operation indexes, blood loss and complication were analyzed. Results All the patients were performed the surgery successfully. The mean time of operation was 13 minutes. No massive blood loss, bladder perforation, obturator nerve reflex, and other serious complication occurred. Those simple bladder tumor just needed bladder washing 2 to 6 hours after operation, catheterization for 48 h. All patients were given postoperative bladder irrigation with pirarubicin and followed up for 3 to 12 month. There was no recurrence of tumor. Conclusion Straight light green laser and water-jet en bloc enucleat can enucleat the whole mass, and has the advantages of shorter operation time, less bleeding, and less complications. It's a safe and efficient method for bladder tumor.
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