腔内钬激光治疗尿路非浸润性移行细胞肿瘤45例报告  

Holmium:YAG Laser Resection for non Muscle-invasive Urothelial Cancer:a Report of 45 Cases

作　　者：周治军[1] 徐康[1] 章尹岗[1] 万涛[1] 龚化[1] 熊标[1] 

机构地区：[1]湖北省天门市第一人民医院泌尿外科,湖北天门431700

出　　处：《临床泌尿外科杂志》2011年第11期835-836,共2页Journal of Clinical Urology

摘　　要：目的:探讨钬激光治疗浅表性输尿管及膀胱肿瘤的手术方法及疗效。方法:2008年7月～2011年4月采用钬激光治疗浅表性输尿管肿瘤3例,治疗膀胱侧壁浅表性肿瘤42例。其中,输尿管肿瘤冠顶直径0.5～1.0 cm,带蒂,1例为孤立肾,1例对侧肾发育不良,1例年老体弱,合并房颤,均为单发。膀胱侧壁肿瘤冠顶直径0.5～6.0 cm,平均1.2 cm,肿瘤单发38例,多发4例。原发肿瘤37例,非原位复发肿瘤8例。术后随访3个月～3年。结果:45例手术几乎无出血,无输尿管及膀胱穿孔。术后随访至今,3例输尿管瘤均未复发,42例膀胱癌8例复发,无原位复发及远处转移。结论:钬激光治疗膀胱侧壁肿瘤无闭孔神经反射,可明显减少膀胱穿孔的发生率;治疗特殊病例的输尿管肿瘤具有创伤小、恢复快、术后并发症少等优点,同时明显降低术后发生肾功能不全的风险,提高生活质量。Objective： To investigate the value of Ho ： YAG laser in the treatment of non muscle-invasive urothelial cancer. Methods：Three cases of non musele-invasive ureteral cancer and 42 cases of non muscle-invasive lateral wall bladder cancer were treated with Ho ： YAG laser from July, 2008 to Apr, 2011. The diameters of three ureteral cancer were 0.5-1.0 cm, all were solitary. Among them, one case was solitary kidney, one case the contralateral kidney was dysplasia, and one case was old and had atrial fibrillation. The diameters of forty-two cases of bladder cancer were 0.5-6 cm, of which 38 cases were solitary and 4 cases were multiple, 37 cases were primary and 8 cases were recurrent. All cases were followed up for 6 months to 3 years. Results：No severe bleeding, ureteral or bladder perforation was occurred during operation. No recurrence was found in 3 cases of ureteral cancer. Eight cases of 42 bladder cancer were found recurrent, without the in situ recurrence and distant metastases. Conclusions： Ho ： YAG laser reduces the incidence of obturator nerve reflex when treating lateral wall bladder cancer, thereby decreases the incidence of bladder perforation. And the laser is a minimally invasive, quick recovery surgery and has less postoperative complications when treating some special ureteral cancer.

关 键 词：膀胱肿瘤 输尿管肿瘤 钬激光 

分 类 号：R737.14[医药卫生—肿瘤]