经尿道2微米激光膀胱部分切除术治疗膀胱肿瘤1年随访观察  

Transurethral partial cystectomy using a 2 μm continuous wave laser in treatment of bladder carcinoma： 1-year follow-up

作　　者：魏志涛[1] 许勇[1] 徐峰[2] 杨勇[1] 郭刚[1] 洪宝发[1] 张旭[1] 

机构地区：[1]解放军总医院泌尿外科,北京100853 [2]航天中心医院泌尿外科

出　　处：《中华外科杂志》2010年第3期221-223,共3页Chinese Journal of Surgery

摘　　要：目的总结分析经尿道2μm激光膀胱部分切除术治疗的膀胱肿瘤患者术后1年的临床随访效果。方法在2007年12月至2008年5月间，选取门诊和住院的膀胱尿路上皮癌患者47例，采用经尿道2μm激光膀胱部分切除术进行治疗。分析手术特点，观察术中及术后并发症，术后病理分期特点；总结并分析膀胱肿瘤患者术后一年随访结果和特点。结果所有患者在骶管麻醉下均可耐受经尿道2μm激光膀胱部分切除术。手术时间5～15min，术中几乎不出血，无闭孔神经反射，术后亦无继发出血；术后大体标本可清楚判定肿瘤临床分期；术后出现腹膜穿孔1例，给予手术引流治疗后好转；术后患者均获得随访12—17个月，中位随访15个月，无原位复发。随访期生存率100％。结论通过1年的随访观察，经尿道2μm激光膀胱部分切除术治疗膀胱肿瘤被证实是安全有效的。手术所获得的大体组织标本可以满足病理学检查，明确临床分期，达到了膀胱部分切除术的目的。Objective To summarize and analyze the clinical features of bladder tumor patients who received transurethral partial cystectomy by 2 μm continuous wave laser, in 1 year post operation follow-up visits. Methods From December 2007 to May 2008, 47 bladder carcinoma patients were treated with 2 μm laser transurethrally under sacral block. Operation characteristics, operation time, intraoperative hemorrhages and postoperative complications, and pathology staging of the tumor were observed and postoperative follow-up visits were performed. Results All of the operation procedures were successful. The surgery time was 5 to 15 minutes. Blood loss in the operation was minimal. There was no obturator nerve reflection, and no hemorrhaging was detected after the operation. The pathological stages can be judged correctly with the obtained specimens. There was one case with peritoneum perforation. The patients received 12 to 17 months of postoperative follow-up visits, and there was no recurrence at the resection site. The survival rate was 100%. Conclusions Transurethral partial cystcctomy in the treatment of bladder tumor by 2 μm continuous wave laser is a safe, efficient and effective method. The tumor and all the basal part of bladder wall could be excised completely and the pathological stages can be judged correctly using these specimens to fulfill partial cystectomy for the treatment of bladder carcinoma.

关 键 词：膀胱肿瘤 激光手术 部分切除术 随访 

分 类 号：R737.14[医药卫生—肿瘤] R562.25[医药卫生—临床医学]