自制"钳举"辅助器在经尿道膀胱肿瘤整块剜除治疗非肌层浸润性膀胱癌的应用  

The application of self-made "forceps lifting" auxiliary device for en-bloc resection of bladder tumor through urethra in the treatment of non-muscular invasive bladder cancer

作　　者：王伟峰[1] 张军 万建省[1] 刘四明 邹源 郑少秋 郝继东[1] 廖国强[1] 龚华 欧阳磊 Wang Weifeng;Zhang Jun;Wan Jiansheng;Liu Siming;Zou Yuan;Zheng Shaoqiu;Hao Jidong;Liao Guoqiang;Gong Hua;OuYang Lei(Department of Urology,Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital,Shanghai 201318,China;Graduate School,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海健康医学院附属周浦医院,201318 [2]上海中医药大学研究生院,201203

出　　处：《中华腔镜泌尿外科杂志（电子版）》2024年第1期36-40,共5页Chinese Journal of Endourology(Electronic Edition)

基　　金：浦东新区卫生健康委员会卫生计生科研面上项目(PW2020A-29);浦东新区卫生健康委员会学科建设项目(PWZzk2022-22)

摘　　要：目的探讨自制"钳举"辅助器行经尿道膀胱肿瘤整块切除治疗非肌层浸润性膀胱癌的临床效果。方法回顾性分析2021年3月至2023年1月上海健康医学院附属周浦医院64例非肌层浸润性膀胱癌患者的临床资料,分普通组与改良组,各32例,普通组采用传统经尿道膀胱肿瘤钬激光整块剜除术,改良组采用自制"钳举"辅助器行经尿道膀胱肿瘤钬激光整块剜除术。比较两组患者手术时间、术中血红蛋白下降情况、手术并发症和肿瘤原位复发情况。结果所有患者手术顺利,改良组血红蛋白下降(5±3)g/L,膀胱穿孔率0%(0/32),肿瘤原位复发率3.13%(1/32),普通组血红蛋白下降(6±3)g/L,膀胱穿孔率9.38%(3/32),肿瘤原位复发率12.5%(4/32),两组比较差异无统计学意义(P>0.05);改良组手术时间(19±7)min,短于普通组(25±8)min,差异有统计学意义(P=0.004);改良组肿瘤基底部含有肌层组织者93.75%(30/32),明显多于普通组40.63%(13/32),差异有统计学意义(P<0.001)。结论自制"钳举"辅助器行经尿道膀胱肿瘤钬激光整块剜除术治疗非肌层浸润性膀胱癌,与普通经尿道膀胱肿瘤钬激光整块剜除术具有同样少的手术并发症,安全可靠,因其可以清晰且稳定暴露肿瘤基底,手术时间更短,并可更多地获得肿瘤基底部的肌层组织,有利于肿瘤病理检查。该技术利用现有设备自制,操作简单,值得临床推广。Objective To explore the clinical effect of self-made"forceps lifting"auxiliary device for transurethral bladder tumor en-bloc resection in the treatment of non-muscle invasive bladder cancer.Methods The clinical data of 64 cases of non-muscle invasive bladder cancer in Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital from March 2021 to January 2023 were retrospectively analyzed.They were divided into general group and improved group,32 cases in each group.For enucleation,the improved group used a self-made"forceps lifting"auxiliary device for transurethral en-bloc enucleation of bladder tumors with holmium laser,the general group underwent traditional transurethral holmium laser en-bloc enucleation of bladder tumors.The operation time,intraoperative hemoglobin decrease,surgical complications and tumor recurrence were compared between the two groups.Results The operations of all patients went smoothly.The hemoglobin in the improved group decreased by(5±3)g/L,the probability of bladder perforation was 0%(0/32),the tumor recurrence rate in situ was 3.13%(1/32),and the hemoglobin in the general group decreased(6±3)g/L,the probability of bladder perforation was 9.38%(3/32),and the tumor recurrence rate in situ was 12.5%(4/32),there was no significant difference between the two groups(P>0.05).The operation time of the improved group was(19±7)min,shorter than the general group[(25±8)min](P=0.004);the number of people with muscular layer tissue in the tumor base of the improved group accounted for 93.75%,which was significantly more than that of the general group,which was 40.63%(P<0.001).Conclusions The holmium laser enuclear enucleation of transurethral bladder tumors treated with self-made"forceps lifting"auxiliary device has the same fewer surgical complications as general en bloc holmium laser enucleation of transurethral bladder tumors,and is safe.Because it can clearly and stably expose the tumor base,the operation time is shorter,and more muscle tissue at the base of the tumor can b

关 键 词：膀胱肿瘤 器械辅助 经尿道膀胱肿瘤整块剜除术 

分 类 号：R737.14[医药卫生—肿瘤]