经尿道钬激光切除浅表性膀胱癌的临床体会  

Experience in resecting superficial bladder cancer by transurethral holmium laser

作　　者：陈乐仲[1] 李沈蓉[1] 刘向崇[1] 

机构地区：[1]广东医学院附属深圳西乡人民医院泌尿外科,广东深圳518102

出　　处：《岭南现代临床外科》2011年第6期445-446,共2页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨经尿道钬激光切除浅表性膀胱癌的疗效及安全性。方法对65例浅表性膀胱癌患者采用经尿道钬激光切除治疗。术前膀胱镜活检组织病理均提示低级别尿路上皮癌。结果手术均一次成功,手术时间平均22min(18～45min),无闭孔神经反射、膀胱穿孔及术中无明显出血、术后无继发性大出血及尿失禁等并发症。术后留置导尿2～3d。术后创面基底及创缘病理检查无残余肿瘤。术后住院2～3d。术后均按常规方法定期吡柔比星膀胱灌注,定期膀胱镜复查,定期随访。术后随访平均15个月(3～32个月),2例为膀胱手术区复发,3例为膀胱非手术区再发,复发加再发率为7.7%。再次行钬激光治疗,现仍在随访中,未见复发。结论经尿道钬激光切除浅表性膀胱癌操作简便、安全、创伤小、并发症少、疗效确切。Objective To discuss the clinical effect and safety on the resection of superficial bladder cancer by transurethral holmium laser.Methods Sixty five patients with bladder cancers were resected by transurethral holmium laser..The patients were pathologically confirmed to be low-grade papillary urothelial carcinoma by biopsy.Results The operation was successful on one session in all patients..The mean operation time was 22 minutes（18～45 min）.No complications such as obturatornerve reflex,bladder perforation,and few bleeding in operation,and no secondary hemorrhage occurred after operation.The postoperative catheterization time was 2～3 days.Pathological biopsies of the tumor base and incisional margins were negative.Hospitalization stay after operation ranged from 2 to 3 days.Postoperative intravesical instillation therapy and cystoscopy were done regularly.All patients were followed up for 3～32 months with a mean of 15 months,5 patients（7.7%） had recurrence,and were retreated with laser treatment,no recurrence was found in the 5 patients during follow-up examinations.Conclusion Transurethral holmium laser resection of bladder cancer is simple,safe and effective,and has few injury and complications.

关 键 词：膀胱癌 钬激光 微创手术 

分 类 号：R737.1[医药卫生—肿瘤]