经尿道等离子“V”型电极膀胱肿瘤整块切除术的临床研究(附29例报告)  

Study on en bloc transurethral resection of bladder tumor using V-type plasma electrode

作　　者：祝子清 何露 伍庄 吕艳 吴顺理 郑新民[2] ZHU Zi-qing;HE Lu;WU Zhuang;LV Yan;WU Shun-li;ZHENG Xin-min(Department of Urology,China Resources Wisco General Hospital,Wuhan 430080,China)

机构地区：[1]华润武钢总医院泌尿外科,武汉430080 [2]武汉大学中南医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2018年第3期132-135,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的分析用自行研制的等离子"V"型电极行经尿道膀胱肿瘤整块切除的可行性及临床疗效。方法选取2015年4月至2016年10月华润武钢总医院收治的膀胱癌患者29例作为研究对象,其中男20例,女9例,平均年龄41岁。肿瘤单发11例、多发18例。用5%葡萄糖将吡柔比星20mg稀释至20ml作为标记及填充液,用于膀胱肿瘤基底部注射。用自行研制的等离子体"V"型电极行经尿道膀胱肿瘤整块切除。观察肿瘤整块切除的完整性、膀胱闭孔神经反射发生的频次和幅度及肿瘤局部复发等临床效果。结果 29例患者合计切除肿瘤数66枚,均整块切除,每例分别有1~5枚瘤体,均带蒂,肿瘤大小为0.5~2.0cm。肿瘤病理分期:T123例、T2a3例、T2b3例;病理分级:Ⅰ级5例、Ⅱ级22例、Ⅲ级2例。66枚肿瘤中位于膀胱侧壁的有39枚。术中发生闭孔神经反射12次,无膀胱穿孔及术后膀胱出血等并发症。随访时间10~17个月,未见肿瘤术后原位复发。结论经尿道等离子体"V"型电极膀胱肿瘤整块切除术疗效确切,安全可行。Objective To explore the potential clinical impact and applications of en bloc transurethral resection of bladder tumors using an in-house made V-type plasma electrode. MethodsBetween April of 2015 and October of 2016,29 patients admitted with the diagnosis of bladder tumors to our hospital were selected for the study.There are 20 male patients and 9 female patients with an average age of 41 years old.The growth has been single in 11 and multiple in 18.We used5% glucose diluted pirarubicin hydrochloride for injection 20 mg to 20 ml as a marker and filling fluid for bladder tumor basal injection.Patients underwent surgical resection of bladder tumors using the transurethral V-type plasma electrode.Completeness of bladder tumor resection,frequency and extent of obturator nerve reflex and local tumor recurrence were monitored. Results Bladder tumors were completely removed from 29 patients with total 66 tumors varying from 1-5 each individual and0.5-2.0 cm in size.Pathological reports suggested T1-T2 bincluding 23 cases of T1,3 cases of T2 a,and 3 cases of T2 b.Five cases were clinical stageⅠ and 22 cases were clinical stageⅡ,and 2 cases were clinical stageⅢ.Thirty nine cases had lateral bladder tumor.Only 12 cases had obturator nerve reflex.No bladder perforation or secondary hemorrhage was observed in any patient.Patients′followup period was 10-17 months.No local bladder tumor recurrences was observed. Conclusions Complete removal of bladder tumor using transurethral V-type plasma electrode is practical,effective,and safe.

关 键 词：膀胱肿瘤 整块切除 等离子“V”型电极 

分 类 号：R737.14[医药卫生—肿瘤]