二次经尿道双极等离子电切治疗非肌层浸润性膀胱癌  

Repeat Transurethral Bipolar Plasma Resection for Non - muscle Invasive Bladder Cancer

作　　者：顾建军[1] 郭建华[1] 龚旻[1] 胡巍[1] 陈楚红[1] 祝凤明[1] 伊庆同[1] 王华[1] 田斌强[1] 陈长青[1] 

机构地区：[1]上海市浦东新区南汇中心医院泌尿外科,上海210000

出　　处：《国际泌尿系统杂志》2011年第3期285-287,共3页International Journal of Urology and Nephrology

摘　　要：目的探讨二次经尿道双极等离子电切术（Re—TURBt）治疗非肌层浸润性膀胱癌的疗效。方法2005年12月至2010年10月共收治231例非肌层浸润性膀胱癌，男性175例，女性56例，年龄28～85岁。在初次经尿道双极等离子电切术后根据肿瘤分期和分级以及标本有无肌层组织进行评估，有63例患者在术后4—6周行Re—TURBt，其中Ta期25例，T1期38例；低级别癌29例，高级别癌34例；T1期肿瘤标本内末见肌层组织15例。结果63例非肌层浸润性膀胱癌患者行Re—TURBt，34．9％（22／63）发现有肿瘤残留，其中18例肿瘤未侵犯肌层，Ta期8例，T1期10例；4例肿瘤侵犯肌层：高级别癌的肿瘤残留率较低级别癌高（P〈0．05）；初次电切标本中无肌层的肿瘤残留率较有肌层的高（P〈0．05）。6例患者在初次电切术时肿瘤分期被低估。随访3～59个月；Re—TURBt发现肿瘤残留的患者，36．4％（8／22）复发，高于Re-TUR未发现肿瘤残留的患者（12．2％，P〈0．05）。结论Tl期、高级别或初次电切标本无肌层的非肌层浸润性膀胱癌患者术后4～6周应行Re—TURBt。Re—TURBt能提高分期的准确性。Objectives To investigate the efficacy of repeat transurethral resection of tumor in patients with non - muscle invasive bladder cancer. Methods From December 2005 to October 2010,231 patients（ 175 males, 56 females,aged from 28 to 85 years old） with non muscle invasive bladder cancer were evaluated according to tumor stage, grade and muscle or no muscle tissue in initial transurethral resected sample. 63 patients underwent repeat tran- surethral resection of bladder tumor within 4 to 6 weeks after initial resection. Results Of the 63 cases,34.9% （22/63） had residual tumor and 65.1% （41/63）had no tumor on repeat transurethral resection Of 22 cases with residual tumor 18 had non muscle invasive tumor including 8 in Ta and 10 in TI. Conclusions Routine repeat transurethral resection is advised to non muscle invasive bladder cancer patients with T1 tumor or high grade careinoma or no muscle tissue in initial transurethral resected sample. Repeat transurethral resection could increases the stage accuracy.

关 键 词：膀胱肿瘤 尿道 电外科手术 

分 类 号：R737.14[医药卫生—肿瘤]