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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

20卷

期数:

2014年04期

页码:

297-299

栏目:

临床医学

出版日期:

2014-07-08

文章信息/Info

Title:

Transurethral partial cystectomy with 2μm lasert for bladder tumors: a report of 65 cases 

文章编号:

1006-8147（2014）04-0297-03

作者:

栾祖乾;  李春风;  杨 龙;  李黎明;  崔 喆

（天津医科大学总医院泌尿外科，天津 300052)

Author(s):

LUAN Zu-qian;  LI Chun-feng;  YANG Long;  LI Li-ming ;  CUI Zhe

(Department of Urology，General Hospital , Tianjin Medical University，Tianjin 300052，China)

关键词:

膀胱肿瘤;  经尿道膀胱肿瘤切除;  膀胱部分切除;  激光疗法

Keywords:

bladder tumor;  transurethral resection of bladder tumor;  partial cystectomy of bladder;  ;  laser therapy

分类号:

R737.14

DOI:

-

文献标志码:

A

摘要:

目的：探讨经尿道2μm激光膀胱部分切除治疗膀胱肿瘤的可行性。方法：采用2μm激光治疗膀胱肿瘤65例，其中单发肿瘤41例，多发肿瘤24例，肿瘤直径5~35 mm，59例肿瘤病理为膀胱移行细胞癌，G1-G3，临床分期T1-T2。结果：所有患者均可耐受手术，手术时间8 ~35 min；术中冲洗液颜色始终清亮；均未出现闭孔神经反射、膀胱穿孔、水中毒、尿外渗、继发性出血等并发症。术后留置尿管1周，术后住院71~0 d；随访3~15个月，2例复发，均为异位复发，为女性。组织病理学分析证实，切除的标本可清楚判定肿瘤分期。结论：经尿道2μm激光膀胱部分切除治疗膀胱肿瘤的方法安全有效，并且该术式能够提供完整的肿瘤组织架构，对肿瘤的病理检查分期、分级更为容易，其效果等同与开放膀胱部分切除术。

Abstract:

Objective：To discuss the feasibility of the transurethral 2 μm laser partial cystectomy for bladder tumor. Methods: 2-micron laser was used for the treatment of 65 cases of bladder cancer patients，including 41 cases of single tumor, 28 cases of multiple tumors with tumor diameters between 5 and 35 mm . 59 cases of tumor pathology were bladder transitional cell carcinoma, G1-G3 at clinical stage T1 -T2. Results: All patients underwent operations successfully and the operation time was between 8-35 min; intraoperative rinses color was constantly clear; blood loss was 0-15 ml; none of bladders had obturator nerve reflex, perforation, water intoxication, urinary leakage and secondary hemorrhage did not occur. All had catheter indwelled for 1 week, and 7 to 10 days hospital stay after the operation. Patients were followed up for 3 to 15 months，with 2 cases of ectopic recurrence, both female， and no in-field recurrence．Histopathological analysis confirmed that the resected specimen could clearly reveal the tumor stage. Conclusion: Transurethral 2 μm laser partial resection of bladder is safe and effective for the treatment of bladder tumor. It can provide a full tissue structure of bladder tumor, making it easier in the tumor pathologic grading and staging. The effect of 2 μm laser cystectomy is equivalent to an open resection of the bladder.

参考文献/References:

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[3]Wendt-Nordahl G, Huckele S, Honeck P, et al . Systematic evaluation of a recently introduced 2-microm continuous-wave Thulium laser for vaporesection of the prostate[J]. J Endourol, 2008,22(5):1041
[4]Fried N M, Murray K E. High-power Thulium fiber laser ablation of urinary tissues at 1.94 microm[J]. J Endourol, 2005,19(1):25
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[6]贾永中，罗敏，肖序仁，等. 绿激光和RevoLix 2微米激光治疗浅表性膀胱肿瘤的比较研究[J]. 中国微创外科杂志, 2009,9(7):623
[7]Barber N J. Muir G H. High power K T P laser proststectomy:the new challenge to transurethral resection of the prostate[J]. Curr Opin Urol, 2004,14(1):25
[8]潘铁军， 刘波. 非肌层浸润性膀胱癌的腔内手术治疗现状[J]. 现代泌尿生殖肿瘤杂志, 2011,3(4):193
[9]陈文政，李宏召， 杨勇. 2μm激光治疗非肌层浸润性膀胱肿瘤30例[J]. 中国激光医学杂志, 2013,22(1):38
[10]宋勇，杨勇，洪宝发，等. 2μm激光气化切除表浅性膀胱肿瘤72例报告[J]. 临床泌尿外科杂志, 2009,24(5):370
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备注/Memo

备注/Memo:

作者简介 栾祖乾（1987-9），男，硕士在读，研究方向：激光治疗膀胱肿瘤； 通信作者： 崔 喆， E-mail： cuizhe9505 @ sina.com。

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更新日期/Last Update: 2014-06-06