不同术式治疗膀胱三角区肿瘤的临床分析  

Clinical analysis of different surgical treatment of the trigone tumor of the bladder

作　　者：于俊杰[1] 温儒民[1] 

机构地区：[1]徐州医学院附属医院泌尿外科,江苏徐州221002

出　　处：《国际泌尿系统杂志》2014年第6期864-867,共4页International Journal of Urology and Nephrology

摘　　要：目的 比较经尿道膀胱肿瘤电切术与开放部分切除术在治疗膀胱三角区及其周围肿瘤的手术方法、临床效果以及预后.方法 回顾性分析2011年1月-2013年3月58例膀胱三角区肿瘤患者的病例资料,通过对手术时间、术中出血量、术后住院时间、复发及转移等数据进行统计,对两种术式的操作步骤及手术经验进行比较、总结.随访5-31个月,观察其复发情况.结果 对于三角区非肌层浸润性肿瘤电切手术与开放手术比较,在手术时间、出血量、术后住院天数均有明显优势,差异有统计学意义（P＜0.05）,同时没有增加术后复发、转移、肿瘤种植及肾积水等并发症的风险,创伤小、恢复快、美观;对于局限在膀胱内的浸润性膀胱肿瘤（T2期）,开放部分切除术明显降低了术后复发,减少了手术并发症.结论 对于三角区非肌层浸润性肿瘤,首选电切;对于局限在膀胱内的浸润性膀胱肿瘤（T2期）首选开放手术.Objectives To investigate the surgical technique,clinical effectiveness and prognosis of transurethral resection of bladder tumor （TURBT） and partial cystectomy for bladder cancer （hemicyclic） in the treatment of the tumor in cystic triangle area and its adjacent area.Methods We retrospectively analysed the records of 58 patients who underwent the operation of bladder trigone tumor from January 2011 to march 2013.Variables analyses were compared including operating procedure,operative time,estimated intraoperative hemorrhage,and hospital stay.To observe the recurrence and metastasis,we followed up the patients for 5 - 31 months.Results For non muscle invasive tumor in cystic triangle area,there was significant difference between TURBT group and hemicyclic group in operative time the amount of hemorrhage,and hospital stay after operation （P ＜ 0.05）.At the same time,there was no increased risk of recurrence,metastasis,tumor implantation and postoperative uronephrosis.However,for muscle invasive tumor limited in bladder in cystic triangle area,partial cystectomy significantly can reduce the recurrence and postoperative complications.Conclusions The TURBT is the first choice for non muscle invasive tumor in cystic triangle area.However,for muscle invasive tumor limited in bladder in cystic triangle area,partial cystectomy is the best choice.

关 键 词：膀胱肿瘤 膀胱电切术 

分 类 号：R737.14[医药卫生—肿瘤]