CAJ | 학술논문

目的探讨采用肿瘤基底黏膜下水扩张辅助激光切除治疗单发非肌层浸润性膀胱癌的疗效. 方法全身麻醉或连续硬膜外麻醉下,采用Cook膀胱黏膜注射针在肿瘤基底周围2 cm处黏膜下注射无菌灌注用水,黏膜呈丘状隆起、肿瘤与肌层脱离后,采用钬激光或铥激光沿隆起边缘切除膀胱肿瘤,共治疗12例,常规行肿瘤基底活检,术后常规行膀胱灌注化疗. 结果肿瘤直径0.5～2.3 cm.12例均为膀胱尿路上皮肿瘤,术后病理报告低度恶性倾向尿路上皮乳头状瘤3例,低分级乳头状尿路上皮癌9例;临床分期Ta9例,T13例.12例手术均成功,手术时间20 ～ 45 min.平均25 min;术中出血＜5 ml.12例均未输血,未发生闭孔神经反射及膀胱穿孔、尿外渗,无电切综合征.基底组织活检阴性.术后持续冲洗ld;留置尿管l～4d,平均3d;术后住院3～6d,平均5d.随访4～36个月,未见肿瘤复发. 结论肿瘤基底黏膜下水扩张辅助钬激光切除非肌层浸润性膀胱癌有效、安全,术中、术后并发症少,术后复发率低.
목적 탐토채용종류기저점막하수확장보조격광절제치료단발비기층침윤성방광암적료효. 방법 전신마취혹련속경막외마취하,채용Cook방광점막주사침재종류기저주위2 cm처점막하주사무균관주용수,점막정구상륭기、종류여기층탈리후,채용화격광혹주격광연륭기변연절제방광종류,공치료12례,상규행종류기저활검,술후상규행방광관주화료. 결과 종류직경0.5～2.3 cm.12례균위방광뇨로상피종류,술후병리보고저도악성경향뇨로상피유두상류3례,저분급유두상뇨로상피암9례;림상분기Ta9례,T13례.12례수술균성공,수술시간20 ～ 45 min.평균25 min;술중출혈＜5 ml.12례균미수혈,미발생폐공신경반사급방광천공、뇨외삼,무전절종합정.기저조직활검음성.술후지속충세ld;류치뇨관l～4d,평균3d;술후주원3～6d,평균5d.수방4～36개월,미견종류복발. 결론 종류기저점막하수확장보조화격광절제비기층침윤성방광암유효、안전,술중、술후병발증소,술후복발솔저.
Objective To evaluate the safety and efficacy of submucosa dilation assisted laser resection of bladder tumor for the treatment of solitary non-muscle invasive bladder cancer. Methods A total of 12 patients with solitary non-muscle invasive bladder tumor were treated with the procedure of submucosa dilation assisted laser resection under total intravenous anesthesia or epidural anesthesia.lntravesical instillation chemotherapy was performed according to CUA 2007 guidelines.Patients were followed up for 4 - 36 months after the operation. Results The diameter range of the tumors was 0.5 - 2.3 cm with the clinical stage Ta - T1 and low pathology grade.Submucosa dilation assisted laser resection of bladder tumor was successfully performed on all patients.The average operation time was 25 min (range,20 -45 min ),and the catheter time was 3 d ( range,1 -4 d).The mean volume of bleeding was less than 5 ml,no patient required blood transfusion.No complications such as obturator nerve reflex,bladder perforation and over-hydration occurred.No recurrence occurred during the follow-up. Conclusions Submucosa dilation assisted laser resection of bladder tumor could be an effective,safe,and excellent alternative procedure for the treatment of solitary non-muscle invasive bladder cancer,with few complications and a low recurrence rate.More studies and long-term follow-up should be warranted to ultimately evaluate this procedure.