摘要
目的探讨应用经尿道双极等离子电切系统治疗膀胱癌的安全性和疗效。方法采用英国Gyrus公司的经尿道双极等离子电切系统行经尿道膀胱肿瘤电切术（transurethral resection of the bladder tumor,TURBT）治疗膀胱癌85例,切割电极切除肿瘤直达深肌层,同时扩大到电切距肿瘤基底1 cm范围的正常组织,术后定期膀胱内灌注吡柔比星。结果手术时间10~52 min,平均23 min。术中发生闭孔神经反射19例,其中腹膜外穿孔2例。64例随访3~72个月,平均21个月,复发17例（术后6~12个月3例复发,1~2年9例复发,2~5年5例复发）,行1~4次电切8例,膀胱部分切除5例,全膀胱切除4例;死亡2例,其中1例死于心机梗死,另1例死于肿瘤广泛转移。结论双极等离子电切系统行TURBT治疗浅表性膀胱癌是一种安全有效的方法,但仍要防止闭孔神经反射的发生。
Objective To investigate the safety and therapeutic effect of transurethral bipolar plasma resection of bladder tumor. Methods We performed TURBT to treat 85 cases of bladder cancer by transurethral bipolar plasma system from Gyrus,England.Cutting electrode was used to resect the tumor,involving the normal mucosal membrane,away from the base of the tumor by 1 cm,reaching the deep muscle layer of the bladder.After the procedure,pirarubicin were used for intravasical instillation. ResultsThe operation time ranged from 10 to 52 min with a mean of 23 min;during which obturator nerve reflex occurred in 19 cases,and extraperitoneal perforation was found in 2 cases.Follow-up was achieved in 64 patients for 3 to 72 months（mean,21 months）;during the period,17 cases was found relapsed（3 cases in 6-12 months postoperatively,9 cases in 1-2 years,and 5 cases in 2-5 years）,and thus received electronic resection for 1-4 times（8 cases）,partial cystectomy（5 cases） or total cystectomy（4 cases）.Two of the 64 patients died.Cause of death was myocardial infarction and widespread metastasis respectively. ConclusionTransurethral resection of bladder tumor by bipolar plasma is safe and effective for superficial bladder carcinoma;prevention of obturator nerve reflex during the procedure should be considered.
出处
《中国微创外科杂志》
CSCD
2010年第10期870-872,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
膀胱癌
双极等离子
经尿道膀胱肿瘤电切术
Bladder carcinoma
Bipolar plasma
Transurethral resection of bladder tumor
