经尿道等离子电切联合钬激光切除治疗膀胱浅表性肿瘤  

Plasmakinetic Bipolar Vaporized Resectoscopy Combined with Holmium Laser for Superficial Bladder Carcinoma

作　　者：陈国强[1] 陈晨[1] 刘洪涛[1] 张自刚[1] 蒋冬非[1] 唐秀泉[1] 刘湘彬[1] 

机构地区：[1]大庆油田总医院泌尿外科,大庆163001

出　　处：《中国微创外科杂志》2010年第7期632-634,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经尿道等离子双极电切联合钬激光切除治疗膀胱浅表性肿瘤的疗效及安全性。方法 2007年5月～2009年5月对70例多发(2～3个)膀胱肿瘤(Ta～T2a)采用英国Gyrus等离子双极电切联合美国科以人Lumenis100W钬激光切除,钬激光550μm光纤由等离子电切镜操作通道置入切除肿瘤,治疗参数为0.5～1.5J/10～25Hz,总功率15～40W,平均32W。对输尿管口外上方易发生闭孔神经反射区域的肿瘤应用钬激光切除肿瘤,自瘤体基底部切除;其他部位肿瘤采用等离子电切,由肿瘤表面逐渐切除肿瘤,直达肌层。结果 70例膀胱肿瘤均一次切除,手术时间10～45min,平均22min。术中无闭孔神经反射、膀胱穿孔发生。术后保留导尿时间1～6d,平均3d。70例随访6～12个月,平均8.4月,复发4例(5.7%)。结论经尿道等离子电切联合钬激光切除膀胱肿瘤疗效确切、安全性高。Objective To explore the effectiveness of the combination of plasmakinetic bipolar vaporized resectoscope and holmium laser in the treatment of bladder tumors. Methods A total of 70 patients with bladder tumors （stage Ta-T2a） were treated by Gyrus plasmakinetic bipolar vaporized resectoscope combined with holmium laser （Lumenis 100 W,550 μm optic fiber） in our hospital during May 2007 to May 2009. The laser power was set at 15-40 W （mean,32 W） with 0.5-1.5 J/10-25 Hz. The tumors next to the ureteral orifice were incised from the pedicel by laser. And the other regional tumors were resected by plasmakinetic bipolar vaporized resectoscopy. Results Of all the cases,bladder tumors were successfully resected in one operation.The mean operation time was 22 min （raged from 10 to 45min）.No obturator nerve reflex,bladder perforation,or overhydration occurred during the operation. The postoperative catheterization time was 1-6 days （mean,3 days）.The patients were followed up for 6 to 12 months with a mean of 8.4 months,during which 4 cases （5.7%） had recurrence. Conclusions Plasmakinetic bipolar vaporized resectoscope combined with holmium laser is effective and safe for the treatment of bladder tumors.

关 键 词：膀胱浅表性肿瘤 等离子双极电切 钬激光 

分 类 号：R737.14[医药卫生—肿瘤]