T2a期膀胱尿路上皮癌行二次电切治疗的应用价值  

Application value of secondary electrotomy for stage T2a urothelial carcinoma of the bladder

作　　者：周先明[1] 疏仁义[1] 郭荣利[1] 董平[1] 柯磊磊 黄进[1] 夏伟 Zhou Xianming;Shu Renyi;Guo Rongli;Dong Ping;Ke Leilei;Huang Jin;Xia Wei(Department of Urology,the People's Hospital of Chizhou,Anhui 247000,China)

机构地区：[1]池州市人民医院泌尿外科,安徽247000

出　　处：《中华腔镜泌尿外科杂志（电子版）》2019年第2期125-127,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨二次根治性电切术在T2a期膀胱尿路上皮癌治疗上的应用价值,为临床应用提供参考。方法回顾性分析2011年3月至2017年2月首次入住我科拒绝行根治性膀胱切除术或不能耐受根治手术的52例CT分期T2a膀胱尿路上皮癌患者(术后病理证实),其中22例行二次电切治疗的为A组,30例行一次电切治疗的为B组。两组手术均由高年资主治以上医师操作完成。术后行膀胱灌注化疗药物治疗并长期随访。结果 A组:其中1例二次电切时发现膀胱内大量坏死组织,电切困难,遂改为膀胱部分切除术,术后病理为低级别非浸润性膀胱癌,21例行二次根治性电切术,随访1～67个月(平均43个月),复发5例,复发率22.7%,均保留膀胱。B组:随访15～54个月(平均40个月),22例复发,7例丢失膀胱,1例肿瘤肺转移死亡。结论二次膀胱电切术为T2a期膀胱癌提供一种新的治疗选择,有助于保留膀胱功能,可能对临床有一定的意义。Objective To explore the application value of secondary radical electrotomy in the treatment of stage T2a urothelial carcinoma of the bladder,to provide reference for clinicians.Methods Clinical data of 52 patients who were diagnosed with stage T2a urothelial carcinoma of the bladder on CT image(confirmed by postoperative pathology),refused or could not tolerate radical cystectomy admitted to our hospital for the first time from March,2011 to February,2017 were retrospectively analyzed.Among them,22 patients undergoing twice electrotomy were assigned in group A and 30 patients receiving once electrotomy were allocated in group B.In both groups,electrotomy was performed by experienced surgeons.Postoperative intravesical chemotherapy and long-term follow-up were conducted.Results In group A,a large quantity of necrotic tissues was detected in the bladder of one patient during the secondary electrotomy.Intraoperatively,it was difficult to perform electrotomy,which was switched to partial cystectomy.Postoperatively,the patient was pathologically diagnosed with low-grade non-invasive bladder cancer.Twenty-one patients underwent secondary radical electrotomy and were followed up for 1-67 months,43 months on average.Five cases recurred with a recurrence rate of 22.7%.All patients preserved the bladder.In group B,postoperative follow-up endured for 15-54 months(40 months on average).Twenty-two patients recurred,the bladder was resected in 7 cases and 1 patient died of lung metastasis.Conclusion Secondary electrotomy provides a novel treatment option for T2a stage bladder cancer,which can preserve the bladder function and may be of clinical significance.

关 键 词：膀胱尿路上皮癌 膀胱肿物切除术 回顾性分析 

分 类 号：R737.14[医药卫生—肿瘤]