高频能量发生器经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌(附43例报道)

目的 探讨应用高频能量发生器(HFG)经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的安全性和有效性.方法 采用HFG的能量助推双极等离子电切单元行经尿道膀胱肿瘤电切术(TURBT)治疗非肌层浸润性膀胱癌43例,能量助推混切电极切除肿瘤直达深肌层,同时扩大到电切距肿瘤基底边缘1cm范围的正常组织,术后个体化定期膀胱内灌注羟基喜树碱.结果 手术时间15 ～ 55min,平均30min.全组无膀胱穿孔病例,31例侧壁或伴发侧壁肿瘤者有15例发生不同程度的闭孔神经反射.全组随访6 ～18个月,复发4例,均行再次电切.结论 HFG经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌安全有效.

A report of transurethral resection with high-frequency generator in 43 cases non muscle-invasive bladder tumor

Objectives To investigate the safety and therapeutic effect of transurethral resection of bladder tumor with high-frequency generator.Methods We performed TURBT to treat 43 cases of non muscle-invasive bladder cancer(NMIBC) by transurethral boost-pulse bipolar plasma system of high-frequency generator from KLS Martin corporation of Germany.Blend-electrode used to resect main part of the tumor, involving the normal mucosal membrane, away from the base of the tumor by 1 cm, reaching the deep muscle layer of the bladder.Within one year after the procedure, hydroxycamp-tothecine (HCPT) were used for intravasical instillation in regular intervals according to individualization.Results The operation time ranged from 15 to 55 minutes with a mean of 30 minutes;during which obturator nerve reflex to varying degrees occurred in 15 cases with side-wall tumor of 31 ones, and no cases was found occurring extraperitoneal perforation.Follow-up was achieved in 43 patients for 6 to 18 months;during the period, 4 cases was found relapsed and thus received electronic resection.Conclusions Transurethral resection of bladder tumor with high-frequency generator is one of the best safe and effective method to treatment of NMIBC.