2μm激光联合丝裂霉素治疗表浅性膀胱癌的疗效分析  

Study on 2μm laser in combination with intravesical Instillation of mitomycin for treat- ment of superficial bladder cancer

作　　者：王延东[1] 罗光恒[1] 杨秀书[1] 刘军[1] 陈卫红[1] 孙兆林[1] 

机构地区：[1]贵阳贵州省人民医院泌尿外科,贵州550002

出　　处：《国际泌尿系统杂志》2013年第2期182-184,共3页International Journal of Urology and Nephrology

摘　　要：目的探讨2μm激光联合丝裂霉素治疗表浅性膀胱癌的安全性和有效性。方法自2009年6月至2012年6月共116例表浅性膀胱癌患者入选研究，平均年龄58．3岁。其中，高级别泌尿上皮乳头状癌18例，低级别泌尿上皮乳头状癌93例，低度恶性倾向泌尿上皮乳头状瘤5例。影像学检查包括盆腔CT和排泄性尿路造影均显示没有膀胱外侵犯，淋巴结转移以及上尿路肿瘤性病变。所有患者在连续硬膜外麻醉下行2μm激光肿瘤切除，术后24h内即刻灌注撕裂霉素一次，然后1周后开始连续8周每周膀胱灌注丝裂霉素一次，然后改为每月一次维持治疗12个月。结果116例患者总共201个肿瘤应用2μm激光成功切除，每例患者平均手术时间28min。没有出现闭孔神经反射或膀胱穿孔等严重并发症。所有患者均进行了12个月的膀胱灌注化疗。平均随访时间21．3个月，复发率为9．5％。结论2μm激光联合丝裂霉素治疗表浅性膀胱癌是安全有效的。Objectives To evaluate the safety and efficacy of 2μm laser resection in combination with intravesical instillation of mitomycin for treatment of superficial bladder cancer. Methods From June. 2009 to June. 2012, 116 patients with superficial bladder cancer, 18 cases of high grade urethelial papillary carcinoma, 93 low grade urothelial papillary carcinoma and 5 papillary urothelial neoplasm with low malignant potential, were enrolled in our institute. Imaging methods including CT scan and intravenous pyelography, were performed to exclude extravesical invasion, involvement of lymph nodes and tumor in upper urinary tract. Tumors were resected successfully in patients with 2μm laser under epidural anesthesia. Immediate intravesical instillation of mitomycin was applied in all patients followed with 8 weekly and 10 monthly doses of mitomycin maintenance therapy. Results Total 201 tumors in 106 patients were resected successfully and mean operation time of every patient was 28 minutes. No obtu- rator nerve reflex and severe perforation occurred. All patients underwent 12 months of intravesical mitomycin and tumor recurrence was found in 9.5% patients. Conclusions 2μm laser in combination with mitomycin intravesical instillation was safe and effective for treatment of superficial bladder cancer.

关 键 词：膀胱肿瘤 丝裂霉素 激光 

分 类 号：R737.14[医药卫生—肿瘤]