摘要
目的分析应用2μm激光汽化切割术治疗膀胱肿瘤的临床疗效。方法采用骶管麻醉，经尿道膀胱镜2μm激光汽化切割术治疗56例膀胱肿瘤患者，共切除肿瘤68个。术中分层汽化切割膀胱壁，逐层切除标本并分别送病理检查。观察手术时间，术中出血情况，术中及术后并发症，肿瘤病理分期以及术后随访等情况。结果56例患者均可耐受手术；单个肿瘤平均治疗时间为7min，本组患者手术时间4—15min，平均（8．8±3．3）min；术中出血量极少，无闭孔神经反射，术后亦无继发出血，膀胱穿孔1例；术后肿瘤病理分期：T1期40例患者，共47个肿瘤，他期16例患者，共21个肿瘤；术后随访12—17个月，平均14．5个月，复发3例，1例复发两次，总复发率5．3％。无原位复发。结论2μm激光汽化切割术治疗膀胱肿瘤是一种安全有效的新方法。由于2μm激光可以做到对膀胱壁全层进行精细的分层汽化切除，不仅可以有效地治疗浅表性膀胱肿瘤，也适用于治疗部分浸润性膀胱肿瘤。
Objective To analyze the clinical characteristics of 2 μm continuous wave laser vaporesection for the treatment of bladder tumors. Methods A total of 56 patients with 68 bladder tumors underwent 2 μm laser vaporesection via a transurethral cystoscope under caudal anesthesia. In the operation, the wall of the urinary bladder was vaporized and cut, the muscular layers were removed, and then the specimens were sent for pathological inspection separately. The following variables were recorded： operation time, blood loss, complications during and after the operation, pathology staging of the tumors, and follow-up visit time. Results All patients endured the operation. The mean surgery time was 8. 8 ± 3.3 minutes （range, 4 to 15 minutes）. Blood loss was minimal, no patient experienced an obturator nerve reflection, or a hemorrhage after the operation. The pathology staging of the tumors were as follows ： 40 cases （ total 47 tumors） were T1 stage; 16 cases （total 21 tumors） were T2 stage. The follow-up periods were between 12 to 17 months, and the mean period was 14. 5 months. Tumor recurrences were found in 3 cases, and one patients suffered two recurrences, the total recurrence rate was 5.3%. There was no primary recurrence, Conclusions The 2 μm continuous wave laser is a new, safe and efficacious method for the treatment of bladder tumors. Because the 2 μm laser can vaporize and cut the muscular layers of the bladder finely, it can not only treat superficial bladder tumors efficiently, but also treat some types of invasive tumors of the bladder.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2008年第18期1410-1412,共3页
Chinese Journal of Surgery
