钬激光腔内切除巨大膀胱肿瘤

目的]探讨钬激光腔内治疗巨大膀胱肿瘤的可行性及疗效.方法]对22例巨大膀胱肿瘤患者施行经尿道或耻骨上膀胱造瘘道钬激光切除术,其中2例合并膀胱结石同期行钬激光碎石.结果]18例一次手术切除成功,平均手术时间72 min.3例多发肿瘤2例再次手术,另1例术中出血失控转开放膀胱部分切除手术.术后均获至少12个月随访.9例复发再次或多次行腔内钬激光手术.结论]钬激光腔内切除巨大膀胱肿瘤具有微创、并发症少等优点.患者耐受好恢复快,保留了膀胱及正常排尿功能,尤为适合有蒂腔内生长的巨大膀胱肿瘤.

Resection of Large-sized Bladder Tumour with Holmium Laser

Objective]To explore the feasibility and effect of the treatment of large-sized bladder tumour with holmium laser. Methods] From June 2002 to January 2007, a total of 22 cases of large-slzed bladder carcinoma were treated with VersaPulse Power Suite Holmium Laser 20 W. Lithotripsy of bladder stone was performed simultaneously in 2 cases. Results] Bladder tumors were reseeted with holmium laser once in 21 cases. Laser operating time ranged from 45 to 110 min, with mean of 72 min. Uneontrollable bleeding occurred in 1 case and led to a partial cystectomy. All were followed up for at least 12 months. Tumor recurrences were found in 9 cases, and were reseeted with holmium laser again. Conclusion] Holmium laser resection of largesized bladder tumor is feasible with significant advantage of preservation of bladder and minimal influence to life quality