经尿道等离子棒状电极整块剜除治疗浅表性膀胱癌

目的探讨经尿道等离子棒状电极整块剜除治疗浅表性膀胱癌的有效性和安全性。方法2016年11月~2019年7月,对31例浅表性膀胱癌采用等离子棒状电极行经尿道肿瘤整块剜除术。术前影像学检查提示膀胱肿瘤直径<3.0 cm,未侵犯膀胱肌层。结果手术均获成功,手术时间10~35 min,平均23 min,未出现膀胱穿孔、严重闭孔反射、明显出血及尿失禁等并发症。术后留置尿管2~7天。术后病理提示切缘及基底未见肿瘤组织,术后住院3~7天。均进行吡柔比星或吉西他滨膀胱灌注,定期随访及行膀胱镜检查,术后随访6~40个月,平均20.3月,未见术区复发。结论经尿道等离子棒状电极整块剜除治疗浅表性膀胱癌操作简单快捷,疗效确切,安全。

Use of Transurethral Plasma Column Electrode in the en bloc Resection of Superficial Bladder Cancer

Objective To evaluate the efficacy and safety of transurethral plasma column electrode in the en bloc resection of superficial bladder cancer.Methods A total of 31 cases of superficial bladder cancer in our department from November 2016 to July 2019 were treated by transurethral plasma column electrode en bloc resection.Preoperative color Doppler ultrasonography and bladder CT or pelvic MRI showed that bladder tumors did not invade the bladder muscle layer,and the diameter of bladder tumors was less than 3.0 cm.Results All the operations were successful.The average operation time was 23 min(range,10-35 min).No bladder perforation,severe obturator reflex,obvious bleeding,or urinary incontinence occurred.The postoperative indwelling catheterization lasted for 2-7 days.The postoperative pathology showed that there was no tumor tissue in the margin or basement.The patients were hospitalized for 3-7 days after operation.All the patients received intravesical instillation of pirarubicin or gemcitabine,and were followed up regularly with cystoscopy.There was no tumor recurrence during 6-40 months(mean,20.3 months)of follow-ups.Conclusion Transurethral plasma column electrode en bloc resection of bladder tumor is a simple,effective and safe minimally invasive procedure.