经尿道内镜黏膜下剥离术治疗非肌层浸润性膀胱肿瘤82例疗效分析  

Clinical analysis of 82 cases with non- muscle invasive bladder tumor treated with transurethral endoscopic submucosal dissection

作　　者：程永毅[1] 李晶[1] 屈卫星[1] 孙羿[1] 邹铁军[1] 姜亚卓[1] 徐永刚[1] 杜春[1] 任伟[1] 杜双宽[1] 

机构地区：[1]陕西省人民医院泌尿外科,陕西西安710068

出　　处：《现代肿瘤医学》2016年第20期3249-3252,共4页Journal of Modern Oncology

摘　　要：目的：探讨利用海博刀行膀胱肿瘤内镜黏膜下剥离术（BT-ESD）治疗非肌层浸润性膀胱肿瘤的安全性和有效性。方法：收集2013年11月至2015年8月陕西省人民医院收治的82例非肌层浸润性膀胱肿瘤患者,利用海博刀行BT-ESD治疗膀胱肿瘤病灶。记录患者手术时间、术中出血量、膀胱冲洗时间、尿管留置时间、术后住院时间和1年肿瘤复发率。结果：完整切除膀胱肿瘤78例,肿瘤直径1.0～7.0cm,完整取出肿瘤70例,肿瘤组织电切后取出12例。手术时间（60±19.2）min、膀胱冲洗时间（24±10）h、尿管留置时间（5.9±1.9）d、术后住院时间（5.1±1.2）d。无1例需要输血,1例发生闭孔神经反射,无穿孔及术后出血等并发症。结论：利用海博刀行BT-ESD治疗非肌层浸润性膀胱肿瘤是一种安全有效的方式。肿瘤的完整切除有利于病理学的评估,减少了肿瘤播散和复发的机会。完整切除膀胱肿瘤的方法更符合肿瘤外科治疗原则。Objective： To investigate the efficacy and safety of bladder tumor - endoscopic submucosal dissection （BT - ESD） in patients with non - muscle invasive bladder cancer（ NMIBC） . Methods ： A total of 82 NMIBC patients were treated by surgical treatment from November 2013 to August 2015. All cases were treated by BT - ESD. After surgery, all patients accepted regular intravesical chemical drug instillation, and repeated cystoscope examination every three months. The operation time, blood loss, bladder irrigation time, catheter indwelling time, postoperative hospital stay,complications and 1 - year tumor recurrent rate were recorded. Results： The 78 patients were en bloc dissected from the bladder wall. Tumor diameter 1.0 ？7. 0cm. 70 cases were en bloc removed from bladder and 12 cases wereremoved from bladder after fragment by the use of resectoscope. Operation time was （60 ± 19. 2） min,bladder irriga-tion time was （24 ± 10 ） h,indwelling catheter time was （ 5. 9 ± 1 ？ 9 ） d ＇postoperative hospital stay was （5. 1 ±1.2） d. No case needed blood transfusion. The obturator nerve reflex was found in 1 case with tumor located at the lateral wall. No other complications occurred, such as perforation and postoperative bleeding. Conclusion： BT - ESD with Hy- bridKnife for treatment of non - muscle invasive bladder tumor is a safe and effective approach. Complete resection of the tumor is conducive to evaluation of pathology, reduction in the possibility of tumor spread and recurrence. The en -bloc resection technique is more in line with the oncologic principles of surgery treatment of bladder tumor.

关 键 词：海博刀 非肌层浸润性膀胱癌 膀胱肿瘤内镜黏膜下剥离术 完整切除 

分 类 号：R737.14[医药卫生—肿瘤]