经尿道绿激光汽化术治疗输尿管末端周围膀胱肿瘤(附39例报道)  

Green Laser Vaporization Transurethral Resection for Bladder Tumors Around Ureteral Orifice(Report of 39 Cases)

作　　者：宋伟[1] 金讯波[1] 赵勇[1] 王慕文[1] 王金[1] 李连军[1] 

机构地区：[1]山东大学附属省立医院泌尿微创中心,山东济南250014

出　　处：《泌尿外科杂志（电子版）》2011年第3期15-17,共3页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的探讨经尿道绿激光汽化术治疗累及输尿管末端的膀胱肿瘤手术方法的安全性、可靠性及有效性。方法 2008年2月至2011年8月,本中心39例膀胱尿路上皮癌侵及输尿管末端患者接受经尿道绿激光汽化术。回顾其手术时间、治疗效果及并发症。结果手术时间平均25分钟,术中无闭孔反射,无膀胱穿孔,无TUR综合征,几乎无出血,无输血病例,术中放置输尿管支架管2例,术后留置尿管3～7天。术后均行吡柔比星规律膀胱灌注化疗和膀胱镜定期检查。术后随访3～40个月,平均15个月,复发5例,均在汽化以外部位,复发率12.8%。未见有继发性肾积水的发生。所有患者均存活,无死亡病例。结论经尿道绿激光汽化术治疗累及输尿管末端膀胱肿瘤的方法创伤小、安全可靠,效果确切,对合并有严重心肺功能异常的老年患者可优先选用该方法治疗。Objective To evaluate the safety and efficacy of transurethral photoselective vaporization of the bladder tumors around ureteral orifice. Methods A total of 39 patients, aged 42 to 91years with bladder tumors around ureteral orifice underwent endoscopic KTP laser therapy from February 2008 to August 2011 There were 34 male patients and 5 female patients,with single tumor in 26 patients and multiple tumors in 13 patients. Results All patients underwent operations successfully and the mean operating time was 25 min (range 15~60min). The volume of bleeding was very small and no secondary hemorrhage occurred. No case had obturator nerve reflex,vesical perforation and TUR syndrome. All cases were settled catheter for 3~7 days. The patients were followed up for 3 to 40 months with a mean of 15 months. The recurrence rate of bladder neoplasms was 12.8%. After operation,bladder irrigation and regular inspection with cystoscopes were used. All cases were alive. Conclusions Green laser vaporization transurethral resection for bladder tumors is safe and effective. This operation may become ideal method for treatment of bladder tumors around ureteral orifice.

关 键 词：输尿管口 膀胱肿瘤 光选择性汽化术 

分 类 号：R699[医药卫生—泌尿科学]