表阿霉素黏膜下浸润注射加单次灌注预防浅表性膀胱癌术后复发的研究

目的　探讨表阿霉素膀胱黏膜下浸润注射和术后立即单次膀胱灌注预防浅表性膀胱癌术后复发的临床效果。　方法　浅表性膀胱癌 36例 ,Ta10例 ,T12 6例 ;G111例 ,G2 2 0例 ,G3 5例 ,均行膀胱部分切除。术中采用 1mg/ml浓度的表阿霉素多中心膀胱黏膜下浸润注射 ,总量 30mg。手术结束时立即单次膀胱灌注表阿霉素 12 0mg。 36例患者术后随访 1～ 4年 ,平均 2 .8年。　结果　 36例患者术后 1、2、3年无瘤生存率分别为 10 0 .0 %、91.7%、88.9% ,总复发率 11.1% ( 4 / 36 )。手术前后肝肾功能及心电图无显著性变化。术后早期并发症主要为血尿和膀胱刺激症状 ,膀胱局部毒性反应发生率为 2 7.8% ( 10 / 36 ) ,全身性毒性反应发生率 8.3% ( 3/ 36 )。　结论　术中多中心表阿霉素膀胱黏膜下浸润注射结合单次膀胱灌注预防浅表性膀胱癌术后复发效果良好 ,操作简便 ,费用低 ,毒副作用小

Submucosal injection plus single intravesical instillation of epirubicin for primary superficial bladder carcinoma recurrence

Objective To evaluate the efficacy of submucosal injection plus single intravesical instillation of epirubicin for primary superficial bladder cancer recurrence. Methods A total of 36 patients with superficial bladder carcinoma (10 cases of T a and 26 of T 1;11 cases of G 1,20 of G 2 and 5 of G 3) underwent partial cystectomy.Intraoperatively,submucosal multiple injections of epirubicin (total dose of 30 mg) were performed,and intravesical instillation of 120 mg epirubicin was conducted immediately after operation. All the patients were followed up for 1 to 4 years (mean 2.8 years). Results The postoperative disease free survival rates were 100.0%,91.7% (33/36) and 88.9% (32/36) at 1,2 and 3 years, respectively.The total recurrence rate was 11.1% (4/36),and adverse effect rate was 36.1% (13/36). Conclusions Intraoperative submucosal multiple injections combined with single intravesical instillation of epirubicin immediately after operation are effective for prophylaxis of primary superficial bladder cancer recurrence,with advantage of being more cost effective and fewer side effects.