T_1期膀胱癌需要行再次经尿道膀胱肿瘤电切术吗?  

Do Patients with T1 Tumors of the Bladder Cancer Have to Undergo Repeat Transurethral Resection?

作　　者：姜振明[1] 孔垂泽[1] 宫大鑫[1] 刘涛[1] 都书琪[1] 

机构地区：[1]中国医科大学附属第一医院泌尿外科,沈阳110001

出　　处：《中国医科大学学报》2011年第9期800-802,共3页Journal of China Medical University

基　　金：辽宁省科技厅博士启动基金资助项目(200810161)

摘　　要：目的确定T1期膀胱癌是否有必要行再次经尿道膀胱肿瘤电切术。方法通过膀胱癌数据库分析总结618例罹患T1期膀胱癌患者的临床资料,将其分成有经验医师组和初学者医师组,且2组均有部分患者行再次TRUB术。手术范围是距离肿瘤边缘1.0 cm以上,深度达到深肌层,电切镜下可以见到肌纤维或脂肪样组织。2组患者术后膀胱镜随访1～6年,对检查的结果进行分析总结,并回顾相关文献资料。结果术后4～6周内,有经验医师组患者有11例行再次手术,病理汇报均未见复发;初学者医师组共有7例行再次手术,病理汇报4例为高级别尿路上皮癌。2组膀胱癌共复发96例,术后再发时间为3个月至2.5年,肿瘤距原手术区2.0 cm以外。结论有经验医师行TURB术切除的广度和深度是足够的,且要确定膀胱肌层的情况不留有疑问,没有必要进行再次TURB术。Objective To assess the value of repeat transurethral resection（TUR） in patients with newly diagnosed T1 bladder cancer.Methods We summarized 618 patients′ clinical information in our study.We divided the data into the professional doctors′ team and beginner dogtors＇ team from bladder cancer database team.Our resection margin is 1.0 cm away from the tumor margin,and the deepness was to the deeper muscle layer or met the fat tissue.And some of the patients in each team underwent the Re-TURB.Patients in the both teams were followed up for 1-6 years.Then we analyzed the result and reviewed the involved literature.Result 4～6 weeks after the initial resection,11 patients of the professional doctors′ team were underwent the repeated transurethral resection,all of which were reported non-recurrence through the biopsy.But in the beginner doctors′ team,7 patients were underwent the repeated transurethral resection,in which 5 patients were reported high grade urothelial cancer through the biopsy.And there are overall 96 patients had recurrence in the both teams within 3~30 months,where the recurrence tumor foci was over 2.0 cm far away from the initial foci.Conclusions For the professional doctor,the scope of operation was qualified.The patients should not have to undergo repeated transurethral resection if the muscle biopsy reports no tumor invasion in addition.

关 键 词：T1期膀胱癌 经尿道膀胱肿瘤电切术 再次TURB 肿瘤复发 

分 类 号：R699.5[医药卫生—泌尿科学]