经尿道Ho：YAG激光治疗浅表性膀胱肿瘤的临床分析（附92例报告）

目的：总结经尿道钬激光（Ho：YAG激光）治疗浅表性膀胱肿瘤的临床体会。方法：2005年7月～2008年2月对92例浅表性膀胱癌患者采用Ho：YAG激光治疗，其中肿瘤单发56例，多发36例。肿瘤直径0．5～4cm。术前病理检查均提示为低级别尿路上皮癌。11例年老和一般情况差者采用局麻。结果：手术均一次成功，术后创面基底及创缘病理检查无残余肿瘤，术后均按常规方法用化疗药物行膀胱灌注，并定期随访，每3个月复查膀胱镜。手术时间平均18min（10～50min），出血极少，无膀胱穿孔及术后继发出血等并发症。术后留置导尿1～3天，最短14h。局麻患者术后即可进食并起床活动。术后住院1～3天，其中43例为Et间手术（入院当天手术，第2天出院）。术后随访平均15个月（2～31个月），12例复发（13．3％），再次激光或电切治疗。结论：经尿道Ho：YAG激光治疗浅表性膀胱癌安全，微创，患者耐受性好，疗效与传统TURBT相似。

Clinical Analysis of Transurethral Holmium : YAG Laser for Superficial Bladder Tumor (Report of 92 Cases)

Objective：To discuss the clinical experience of transurethral Ho ： YAG laser in the treatment of superficial bladder tumors. Methods：From July 2005 to February 2008, 92 patients with superficial bladder tumors underwent Ho ： YAG laser treatment. The growth has been single in 56 cases and multiple in 36 cases. The diam- eter of the tumor was 0.5 4.0 cm. Each biopsy was confirmed to be low-grade papillary urothelial carcinoma by pathology. 11 patients went through the operation with local anesthesia because of oldness of other illnesses. Resuits：The procedure has been successful in all, and postoperative biopsies of the tumor basement and incisal margin were negative. Postoperative intravesical instillation therapy was done to all the patients, who underwent cystoscopy every 3 months. The mean operation time was 18 rains（range 10-50 mins）, with few bleeding. Neither intr- aoperative bladder perforation nor secondary hemorrhage occurred. In-dwelling urethral catheter time ranged 1-3 d （minimum ,14 hours）. Patients with local anesthesia could eat and move immediately after operation. Hospitaliza tion stay after operation ranged from 1 to 3 days, including 43 patients＇ stay time was only one day. All patients have been followed up for 2 to 31 months with a mean of 15 months. 12 patient （13.3%） had out of-field recurrence, and then accepted laser treatment or transurethral resection of bladder tumor （TURBT）. Conclusions： Ho： YAG laser treatment of superficial bladder tumors provides an useful clinical therapeutic method that has the advantages of safety and minimal invasion, as well as the similar curative effect of TURBT.