根治性经尿道汽化电切术治疗浸润性膀胱癌的探讨

目的 探讨根治性经尿道膀胱肿瘤汽化电切术治疗浸润性膀胱癌的疗效.方法 2008年2月至2010年2月对36例浸润性膀胱癌患者,施行了根治性经尿道膀胱肿瘤汽化电切术,手术参照根治性经尿道膀胱肿瘤电切术原则,肿瘤部位切除至膀胱外脂肪层.术后给予卡介苗膀胱灌注治疗,随访3～24个月.结果 2年内复发12例,复发率33.3%(12/36),对复发者再次行经尿道膀胱肿瘤汽化电切术.2年内死亡6例,病死率16.7%(6/36).结论 对年老体弱不能耐受或不愿意接受膀胱全切的浸润性膀胱癌患者可施行根治性经尿道膀胱肿瘤汽化电切术,以达到延长生命,提高生活质量的目的.

Abstract：

Objective To assess the efficacy of radical transurethral electrovaporization for invasive bladder cancer. Methods Thirty-six patients with invasive bladder cancer from february 2008 to February 2010 were treated by transurethral electrovaporization resection of bladder tumor (TURBT). The operation procedure was based upon the principle of radical transurethral resection for bladder tumor. The tumor was resected to fatty layer outside the bladder wall. After operation Bacillus Calmette-Guerin (BCG) irrigation of bladder was given,all patients were followed up for 3 to 24 months. Results The recurrence occurred in 12 cases in 2 years,with a recurrence rate of 33. 3% (12/36). These recurrence cases were treated with TURBT again. Six cases dead in 2 years,with a mortality of 16. 7% (6/36). Conclusion TURBT is suitable for those who are older or weak,and not medically fit for radical cystectomy or those who refuse the open surgery,which can prolong the survival time and improve the quality of life.     

根治性经尿道电切术与膀胱全切术治疗中晚期膀胱癌疗效分析

目的探讨根治性经尿道膀胱肿瘤电切术（TURBT）治疗中晚期浸润性膀胱癌的疗效。方法对75例浸润性膀胱癌患者,采用根治性TURBT方法42例,按照根治性TURBT手术原则,切除肿瘤至膀胱外脂肪层;采用膀胱全切加盆腔淋巴结清扫,回肠代膀胱术33例。随访时间均为6～24个月。结果根治性TURBT手术时间短、出血少、并发症发生率低,但无法清扫淋巴结,复发率高。2组比较,2年生存率差异无统计学意义（P〉0．05）。结论根治性TURBT可作为中晚期浸润性膀胱癌的一种手术方法,特别适用于高危患者或不愿意接受膀胱全切术的患者,可起到提高患者生活质量,延长生命的目的。