论文部分内容阅读
目的探讨2微米激光治疗非肌层浸润性膀胱肿瘤的近期临床效果。方法非肌层浸润性膀胱肿瘤患者56例。男44例,女12例,中位年龄66岁(28～87岁)。肿瘤单发36例,多发20例。肿瘤直径0.5～3.0cm,术前病理均提示低级别尿路上皮癌。所有患者随机平均分为2微米激光治疗组和经尿道电切组。术后行羟基喜树碱膀胱灌注治疗。总结比较两组的手术时间、导尿管留置时间、术后膀胱冲洗时间、肿瘤复发情况和膀胱穿孔例数等指标。结果手术均一次成功,所有患者术中创面基底及创缘病理检查均无残余肿瘤,全部患者均得到随访,随访时间3～8个月,每3个月接受膀胱镜复查。2微米激光组手术时间是20～50min,平均30min。术后膀胱冲洗6h,留置尿管1～3d,无膀胱穿孔病例,3例复发(10.71%)。电切组手术时间是15～55min,平均28min,术后膀胱冲洗6h,导尿管留置时间1～3d,膀胱穿孔6例,4例复发(12.00%)。两组的平均手术时间、尿管留置时间、膀胱冲洗时间和术后肿瘤复发等指标的差异均无统计学意义(P>0.05),2微米激光组膀胱穿孔例数少于电切组(P<0.001)。结论经尿道2微米激光治疗非肌层浸润性膀胱肿瘤的近期疗效满意,创伤更小,患者耐受良好。
Objective To investigate the short-term clinical effect of 2-μm laser on non-muscle invasive bladder tumor. Methods 56 cases of non-muscle invasive bladder cancer patients. 44 males and 12 females, with a median age of 66 years (28-87 years). Tumor in 36 cases, multiple in 20 cases. Tumor diameter 0.5 ~ 3.0cm, preoperative pathology prompted low-grade urothelial carcinoma. All patients were randomly divided into 2 micron laser treatment group and transurethral resection group. After surgery, hydroxycamptothecin bladder irrigation. The operation time, urinary catheter indwelling time, postoperative bladder irrigation time, tumor recurrence and bladder perforation were compared and summarized. Results All the operations were successful. All the patients had no residual tumor on the wound surface and wound margin. All the patients were followed up for 3 to 8 months and underwent cystoscopy every 3 months. The operation time of 2-μm laser group was 20-50min with an average of 30min. Postoperative bladder irrigation 6h, indwelling catheter 1 ~ 3d, no cases of bladder perforation, 3 cases of recurrence (10.71%). The operation time of the resection group was 15-55 minutes with an average of 28 minutes. The postoperative bladder irrigation 6 hours, the catheterization time 1-3 days, the bladder perforation 6 cases and the recurrence of 4 cases 12.00%. There were no significant differences in mean operative time, catheter indwelling time, bladder irrigation time and postoperative tumor recurrence between the two groups (P> 0.05) <0.001). Conclusion Transurethral 2-μm laser treatment of non-muscle invasive bladder tumor with satisfactory short-term results, less trauma, patients with good tolerance.