经尿道电切治疗膀胱肿瘤78例体会

目的评价经尿道膀胱肿瘤电切(TURBT)治疗表浅膀胱肿瘤的疗效。方法对采用经尿道膀胱肿瘤电切术治疗膀胱肿瘤78例患者的临床资料进行回顾性分析。结果 78例患者均一次手术成功,手术时间10～80 min,平均30 min。6例侧壁肿瘤术中出现闭孔神经反射,采用小功率、间断放电点切及凝切法,辅以静脉麻醉配合短效肌松药,顺利完成手术。5例合并前列腺增生(BPH)同时行经尿道前列腺电切术(TURP)。术中无膀胱穿孔、输尿管口狭窄,出血较少,不需输血。术后无尿路感染及继发性膀胱破裂等并发症。24 h内即完成首次丝裂霉素20 mg或表柔比星30 mg膀胱灌注。所有病例随访0.6～9年,有14例复发,发率为17.9%,12例再次行TURBT,2例作开放性膀胱部分切除术,术后改用卡介苗(BCG)膀胱灌注,未遗留其他并发症。结论 TURBT具有创伤小、痛苦小、恢复快、疗效满意、并发症少、操作简单、可反复进行等优点,是治疗表浅膀胱癌的首选术式。

Transurethral Resection of the Prostate for the Treatment of Bladder Tumor(Report of 78 Cases)

Objective To evaluate the effects of transurethral resection of bladder tumor(TURBT) in treating superficial bladder tumor.Methods Clinical analysis of 78 cases with superficial bladder tumor treated by TURBT was conducted.Results All of the 78 cases were cured after one operation.The median operation time was 30 min(10-80 min).The adductor reflex was found in 6 cases with tumor located at the lateral wall,using low power,intermittent discharge point-cut and coagulate incisive method assisted by vein anesthesia combined with short effect muscle relaxant,and operations were completed smoothly.5 cases complicated with benign prostatic hyperplasia(BPH) were carried out transurethral resection of the prostate(TURP) simultaneously,without transfusion or perforation of bladder,or narrow ureteral orifice,with a small amount of hemorrhage,and did not require blood transfusions,with.There was no complication of urinary tract infection after operation and secondary bladder rupture,completing mitomycin 20mg and epirubicin 30mg intravesical instillation within 24 hours after operation.During 0.6 to 9 years follow-up period,14 of 78 cases recurred(17.9%).12 patients were treated with re-operation by TURBT,and 2 patients undergone opening partial cystectomy,with postoperative BCG intravesical instillation,without any other complication.Conclusion The TURBT became the primary operative procedure for superficial bladder tumor because of its advantages of minimal invasion,slight pain,rapid recovery,satisfactory efficacy,less complication,simple operation and repeatedly performable process.