2μm激光汽化切除术同期治疗浅表性膀胱癌合并BPH的临床研究

目的:总结2μm激光汽化切除术同期治疗浅表性膀胱癌并前列腺增生(BPH)的临床经验。方法:回顾性分析采用2μm激光汽化切除术同期治疗浅表性膀胱癌并BPH患者24例的临床效果。结果:所有患者手术均获成功,手术时间为76~165min,平均118min,无膀胱穿孔等并发症发生。术后7~9天拔除尿管,发生暂时性尿失禁1例,继发性出血1例。术后随访3~24个月,5例膀胱肿瘤复发,无尿道狭窄等并发症发生。术后3个月,国际前列腺评分由术前(26.29±1.81)分降至术后(12.63±2.41)分(P0.05),生活质量评分由术前(5.04±0.81)分降至术后(1.54±1.14)分(P0.05),最大尿流率由术前(4.67±2.87)ml/s升至术后(14.83±2.14)ml/s(P0.05),膀胱剩余尿量由术前(68.04±18.89)ml降至术后(21.88±11.38)ml(P0.05)。结论:2μm激光汽化切除术是同期治疗浅表性膀胱癌并BPH的一种安全、有效的方法。

Clinical study of vaporesection using 2-micron continuous wave laser for concurrent treatment of superficial bladder cancer combined with BPH

Objective：To summarize the clinical experience of vaporesection using 2-micron continuous wave la- ser for concurrent treatment of superficial bladder cancer combineed with BPH. Method：Retrospective analysis was performed in 24 patients with superficial bladder cancer combined with BPH undergoing 2 micron continuous wave laser treatment. Result：All operations were completed successfully. The average operation time was 118 （range, 76 165） min. During the operation, there was no bladder perforation or other complications occurred. Urinary catheter was withdrawn seven to nine days after the operation. Transient postoperative incontinence occurred in one case and secondary hemorrhage was also found in one case. The tumor recurred in five patients and there was no urethral stricture and other complications occurred during the follow-up period of 3 24 months. The data of postoperative three months were as follows： IPSS decreased from （26.29 ± 1.81 ） preoperatively to （12.63±2.41 ） postoperatively （P〈0.05） ; quality of life （QOL） score decreased from （5.04±0.81） before operation to （1.54＋_ 1.14） after operation （P〈0.05） ; Q increased from （4.67±2.87） ml/s preoperatively to （14.83±2. 14） ml/s postoperatively （P〈0.05）; bladder post void residual （PVR） decreased from （68.04±18.89） ml before opera tion to （21.88± 11.38） ml after operation （P〈0.05）. Conclusion . Concurrent treatment of vaporesection using 2 micron continuous wave laser is safe and effective for superficial bladder cancer combined with BPH.