膀胱副神经节瘤:单中心7例报告

目的归纳膀胱副神经节瘤的临床一般特征、诊断及治疗。方法收集兰州大学第二医院2013年3月—2020年8月所有膀胱肿瘤患者术后病理结果,对术后病理证实为副神经节瘤的7例患者的临床资料及随访结果进行回顾性分析。结果7例中术前明确诊断2例。7例均成功完成手术治疗。经尿道膀胱肿瘤电切术4例[2例术程平稳;2例术中出现血压剧烈波动,经过积极降压1例最终完成手术、另1例取活检后终止手术(院外积极酚苄明准备,3月后再次入院行腹腔镜下膀胱部分切除术)];1例行经尿道膀胱肿瘤激光剜除术,术程平稳;腹腔镜下膀胱部分切除3例(包括上述因术中血压无法有效控制中止手术者1例),平均手术时间130(30~180)min,平均术中出血30(20~50)mL。术后无相关并发症发生,术后住院3~5 d后恢复良好出院。1例发现肿瘤远处转移建议转外院继续治疗。7例均获随访,全身转移1例于外院治疗效果不佳,其余6例症状均有所改善,影像学检查未发现复发征象。远期结果仍有待进一步随访。结论膀胱副神经节瘤术前明确诊断困难,往往误诊为膀胱恶性肿瘤。手术为一线治疗方式,腹腔镜下膀胱部分切除术体现出微创优势,术后恢复快,部分选择性病例采用经尿道膀胱肿瘤电切术,同样可取得良好临床结果。

Paraganglioma of bladder:a report of 7 cases from a single center

Objective To summarize the clinical features,diagnosis and treatment of paraganglioma of bladder.Methods The postoperative pathological results of all patients with bladder tumor treated during Mar.2013 and Aug.2020 at our hospital were collected,cases of paraganglioma were screened,and the clinical data and follow-up results were summarized.Results A total of 7 cases were screened,including 2 cases confirmed before operation,and all of them completed operation successfully.Distant metastasis was found in 1 case,who was transferred to another hospital for further treatment.Transurethral resection of bladder tumor was performed in 4 cases,2 of whom had stable course of operation,but 2 had blood pressure fluctuated sharply.After active control of blood pressure,1 case finally completed the operation,and the other case terminated the operation after biopsy.After out-of-hospital active phenolbenzamine preparation,this case received laparoscopic partial cystectomy 3 months later.Transurethral laser enucleation of bladder tumor was performed in 1 case,and laparoscopic partial cystectomy was performed in 3 cases(including the above-mentioned case in which the operation was aborted due to ineffective control of intraoperative blood pressure fluctuation,their average operation time was 130(30-180)min,and the average intraoperative blood loss was 30(20-50)mL.No complications occurred after operation,and all patients were discharged 3-5 days with good recovery.All 7 cases were followed up;1 case of systemic metastasis was treated in another hospital,but the therapeutic effect was not satisfactory;the other 6 cases recovered well,with no signs of recurrence observed.However,the long-term results still needed further follow-up.Conclusion It is difficult to diagnose bladder paraganglioma before operation;as a result,it is often misdiagnosed as bladder malignant tumor.Operation is the first-line treatment.Laparoscopic partial cystectomy has the advantages of minimally invasive surgery and fast recovery after operation.For some selective cases,transurethral resection of bladder tumor can also have good clinical results.