CAJ | 학술논문

目的：探讨经尿道针状电极膀胱肿瘤切除术中采取膀胱黏膜剥脱法处理输尿管口旁肿瘤的可行性及疗效。方法：5例膀胱肿瘤患者,肿瘤均位于输尿管开口10cm内。采用硬膜外麻,以等离子针状电极距肿瘤周边1cm电凝正常膀胱黏膜后,将针尖插入黏膜下层,将肿瘤所在部位膀胱黏膜完整剥脱,观察手术时间、术中闭孔神经反射发生情况、术中及术后并发症、肿瘤病理分期。结果：共切除输尿管口旁肿瘤5枚,单枚肿瘤切除时间5~15min,平均(78±62)min；所有病例均未行闭孔神经阻滞,术中均无闭孔神经反射发生,术中出血极少,术后无继发出血,留置尿管24~48h 。切除肿瘤均获得完整病理分期：Ta 期4枚,T1期1枚。随访3~6个月未见肿瘤复发,无输尿管反流、输尿管口狭窄、肾及输尿管积水等并发症发生。结论：经尿道针状电极膀胱肿瘤切除术采用黏膜剥脱法治疗输尿管口旁浅表性膀胱肿瘤,其操作简单,创伤小,并发症少,但远期疗效尚需进一步观察。
목적：탐토경뇨도침상전겁방광종류절제술중채취방광점막박탈법처리수뇨관구방종류적가행성급료효。방법：5례방광종류환자,종류균위우수뇨관개구10cm내。채용경막외마,이등리자침상전겁거종류주변1cm전응정상방광점막후,장침첨삽입점막하층,장종류소재부위방광점막완정박탈,관찰수술시간、술중폐공신경반사발생정황、술중급술후병발증、종류병리분기。결과：공절제수뇨관구방종류5매,단매종류절제시간5~15min,평균(78±62)min；소유병례균미행폐공신경조체,술중균무폐공신경반사발생,술중출혈겁소,술후무계발출혈,류치뇨관24~48h 。절제종류균획득완정병리분기：Ta 기4매,T1기1매。수방3~6개월미견종류복발,무수뇨관반류、수뇨관구협착、신급수뇨관적수등병발증발생。결론：경뇨도침상전겁방광종류절제술채용점막박탈법치료수뇨관구방천표성방광종류,기조작간단,창상소,병발증소,단원기료효상수진일보관찰。
To-investigate-the-feasibility-and-effect-of-mucosa-denudati-on-during-transurethral-needle-e-lectrode-resecti-on-of-bladder-tumor-(TUNER--BT)in-the-treat-ment-of-superficial-peri--ureteral-orifice-bladder-tumors-.-Methods-:5-patients-with-bladder-tumors-l-ocated-1-cm-peri--ureteral-orifice-were-incl-uded-.The-patients-recei-ved-epi-dural-anesthesia-.After-electrocautery-of-the-nor-mal-bladder-mucosa-1-cm-a-way-from-the-tumor-by-coagulati-on-cur-rent-,the-needle-tip-was-inserted-into-the-sub-mucosa-layer-and-the-bladder-tumor-as-well-as-the-mucosa-was-stri-pped-en-bloc-.The-operati-on-time-,obturator-nerve-reflex-,peri-operati-ve-complications-,and-pathol-ogic-stage-of-the-tumors-were-observed-.Results-:5-peri--ureteral-orifice-bladder-tumors-were-resected-with-the-operati-ve-time-of-5-1-5-min-per-tumor-(range-,7??8-±6??2-min-).Obturator-nerve-blockade-is-not-necessary-in-any-case-and-no-obturator-nerve-reflex-occurred-.Peri-operati-ve-bl-ood-l-oss-was-mini-mal-.The-urine-drainage-retained-24-48-h-.The-pathol-ogic-stage-of-tumors-sho-wed-4-in-Ta-,and-1-in-T1-.No-tumor-recurrence-and-no-complications-such-as-stricture-of-uretero-vesical-orifice-,-hydronephrosis-or-vesicoureteral-refl-ux-occurred-during-a-follow--up-of-3-6-months-.Conclusions-:Denudati-on-of-the-bladder-mucosa-by-TUNER--BT-is-a-si-mple-and-reliable-method-during-treat-ment-of-superficial-bladder-tumors-l-oca-ted-near-the-ureteral-orifice-.Ho-wever-,the-long-ter-m-oncol-ogic-outco-mes-re-main-to-be-defined-.