经尿道切除膀胱多发肿瘤和巨大肿瘤

目的:探讨经尿道切除膀胱多发肿瘤和巨大肿瘤的治疗效果。方法:采用经尿道膀胱肿瘤切除（TUR-BT）手术治疗29例膀胱多发肿瘤和/或巨大肿瘤，术后常规膀胱灌注，5例接受系统性化疗。每3个月行膀胱镜检查，必要时再次行TUR-BT手术或全膀胱切除术。结果:术后病理结果均为膀胱癌。随访3-72月，18例存活5年以上。在所有病例中，4例术后1年内死于肿瘤转移，8例无瘤生存，17例术后1-3年复发。复发病例中14例再次或多次行TUR-BT手术，2例行全膀胱切除术，1例行单纯尿流改道手术。结论:经尿道切除膀胱多发肿瘤和巨大肿瘤可以获得较好的治疗效果，根治性TUR-BT辅以系统性化疗或许是膀胱多发肿瘤和/或巨大肿瘤而又希望保留膀胱的病人的理性选择。

Transurethral resection of multiple and/or huge bladder tumors

Objective:To explore the therapeutic efficiency of transurethral resection of multiple and/or huge bladder tumor.Methods:Twenty-nine patients with multiple and/or huge bladder tumor were treated with transurethral resection of bladder tumor（TUR-BT) and administered routine intravesical irrigation therapy after operation,while only 5 of them accepted postoperative systemic chemotherapy.All patients were investigated with cystoscope every 3 months and underwent a second TUR-BT or total cystectomy if necessary.Results:The pathological outcomes were carcinoma in all cases.All patients were followed up for 3-72 months and 18 of them were survived for more than 5 years.Of all,4 cases died of metastasis within 1 year after operation,8 cases were survival without tumor recurrence or metastasis,17 cases were intravesical recurrence at 1-3 year after operation.Of the recurrent cases,14 cases underwent second or more times TUR-BT,2 cases underwent a total cystectomy,1 case underwent a urinary diversion operation simply.Conclusion:Transurethral resection of multiple and/or huge bladder tumor has good therapeutic efficiency.Radical TUR-BT combined with systemic chemotherapy may be a rational selection for patients who suffered multiple and/or huge bladder tumor but desired to reserve bladders.