经尿道等离子柱状电极膀胱肿瘤整块切除术的疗效  

Effect of transurethral en-bloc resection of bladder tumor with plasma column electrode

作　　者：惠鹏宇[1] 郑亮[1] 杜永辉[1] 贾磊 倪锋[1] 张志刚[1] HUI Pengyu;ZHENG Liang;DU Yonghui;JIA Lei;NI Feng;ZHANG Zhigang(Department of Urological Surgery,Second Affiliated Hospital of Xi′an Medical University,Xi′an,Shaanxi,710038)

机构地区：[1]西安医学院第二附属医院泌尿外科,陕西西安710038

出　　处：《实用临床医药杂志》2020年第23期33-35,共3页Journal of Clinical Medicine in Practice

基　　金：陕西省教育厅科研计划项目(20JK0894)。

摘　　要：目的探讨等离子柱状电极经尿道膀胱肿瘤整块切除术(TUERBT)治疗初发非肌层浸润性膀胱肿瘤(NMIBC)的临床效果与安全性。方法回顾性分析36例术后病理检查确诊为NMIBC行等离子柱状电极TUERBT患者的临床资料,患者术后即刻给予吡柔比星膀胱灌注,之后行维持灌注化疗。观察等离子柱状电极TUERBT的治疗效果。结果36例患者均成功完成手术,肿瘤直径0.5~3.5 cm,平均(2.3±0.7)cm;手术时间10~45 min,平均(24.5±8.5)min;术中出血极少,无膀胱穿孔及闭孔神经反射等并发症;术后膀胱冲洗时间0.5~2.0 d,平均(1.0±0.5)d;留置尿管时间1~3 d,平均(2.3±0.5)d;术后住院时间2~4 d,平均(3.2±0.8)d;术后病理分期Ta 6例,T 130例。随访期间5例(13.9%)复发。结论等离子柱状电极TUERBT的术中解剖层次清楚,术后分期精确,并发症较少,复发率较低,是一种安全可行的手术方式。Objective To investigate the clinical effect and safety of transurethral en-bloc resection of bladder tumors(TUERBT)with plasma column electrode in the treatment of primary non-muscle-invasive bladder cancer(NMIBC).Methods The clinical data of 36 confirmed patients with NMIBC by postoperative pathological examination was retrospectively analyzed.The patients were supplemented with immediate perfusion of pirobilin in the bladder after the operation,followed by maintenance perfusion chemotherapy.The efficacy of TUERBT was observed.Results All 36 patients successfully completed the surgeries.The tumor diameter ranged from 0.5 to 3.5 cm,with mean diameter of(2.3±0.7)cm,the operative time ranged from 10 to 45 min,with mean time of(24.5±8.5)min.Few blood loss during the operation occurred in the surgeries,no complications such as bladder perforation or reflection of obrurator nerve were observed.Postoperative bladder irrigation time was 0.5 to 2.0 d,with mean time of(1.0±0.5)d,the urethral catheterization time was 1~3 d,with mean time of(2.3±0.5)d.Postoperative hospital stay was 2 to 4 d,with mean time of(3.2±0.8)d.There were 6 cases in Ta stage and 30 cases in T 1 stage.During follow-up,5 cases(13.9%)relapsed.Conclusion TUERBT with plasma column electrode is safe and effective in treating NMIBC,has the advantages of clear anatomic stratification,accurate postoperative pathological staging,fewer complication,and lower recurrence rate,so it is a safe and feasible surgical procedure.

关 键 词：膀胱肿瘤 经尿道膀胱肿瘤整块切除术 柱状电极 浸润性膀胱癌 

分 类 号：R737.14[医药卫生—肿瘤] R699.5[医药卫生—临床医学]