绿激光汽化术治疗膀胱肿瘤522例临床观察被引量：3

Clinical observation of green laser vaporization for the treatment of bladder tumor in 522 patients

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摘要目的探讨经尿道膀胱肿瘤绿激光汽化术(PVBT)治疗膀胱尿路上皮癌的疗效及安全性。方法 2010年1月—2015年5月期间,共收治膀胱尿路上皮癌患者522例,其中非肌层浸润性膀胱癌(NMIBC)405例,肌层浸润性膀胱癌(MIBC)117例。均采用PVBT治疗,术后膀胱灌注表柔比星,其中MIBC患者联合术后静脉化疗(吉西他滨+顺铂)。结果 NMIBC组住院时间(7.32±1.28)d,手术时间(27.08±5.36)min,留置尿管时间(2.42±0.34)d,术后随访12~60个月,复发38例(9.4%),其中3例行根治性膀胱切除术,余35例再次行PVBT;405例患者全部存活。MIBC组住院时间(26.18±1.92)d,手术时间(38.32±6.54)min,留置尿管时间(2.72±0.85)d,术后随访12~60个月,复发19例(16.2%),4例患者行根治性膀胱切除术,余15例再次行PVBT;复发者中有6例死于膀胱癌远处转移(2例肺转移,4例骨转移),余111例存活。结论 PVBT是安全、有效的手术方式,尤其适用于NMIBC及不能或不愿行根治性膀胱切除术的MIBC患者。 Objective To investigate the safety and efficacy of photoselective green laser vaporization of bladder tumor （PVBT）. Methods A total of 522 patients with bladder tumor were enrolled in present study from January 2010 to May 2015, including 405 cases of non muscle-invasive bladder cancer （NMIBC） and 117 cases of muscle-invasive bladder cancer （MIBC）. All of patients were treated with PVBT and intravesical instillation of epirubicin. Patients with MIBC received intravenous chemotherapy （kisi-hama and cisplatin）. Results The hospitalization time was （7.32±1.28） days, the operation time was （27.08±5.36） min, and the indwelling urinary catheter was （2.42±0.34） days for patients in NMIBC group. During the follow-up period （12-60 months）, 38 cases （9.4%） relapsed, of which 3 cases underwent radical cystectomy, and other 35 cases underwent PVBT again. All 405 patients were alive at the end of follow-ups. The hospitalization time was（26.18 ± 1.92） days, the operation time was （38.32 ± 6.54） min, and the time of indwelling urinary catheter was （2.72 ± 0.85） days for patients of MIBC group. During the follow-up period （12-60 months）, 19 cases （16.2%） relapsed. Among them, 4 patients underwent radical cystectomy, and other 15 cases underwent PVBT. Six patients died from distant organ metastasis （including 2 cases of pulmonary metastasis and 4 cases of bone metastasis）, and other 111 patients survived. Conclusion PVBT is safe and effective in the clinical application, especially for NMIBC and MIBC patients who are unable or unwilling to undergo radical cystectomy.

作者张志华陈雅童李昭夷张廷继冯起庆李健 ZHANG Zhi-hua CHEN Ya-tong LI Zhao-yi ZHANG Ting-ji FENG Qi-qing LI Jian(Department of Urology, Tianjin Union Medicine Center, Tianjin 300121, China)

机构地区天津市人民医院泌尿外科

出处《天津医药》 CAS 2017年第9期976-979,共4页 Tianjin Medical Journal

关键词膀胱肿瘤复发随访非肌层浸润性膀胱癌肌层浸润性膀胱癌激光治疗绿激光汽化术 urinary bladder neoplasms recurrence follow up non muscle-invasive bladder cancer muscle-invasive bladder cancer laser therapy greenlight vaporization

分类号 R737.14 [医药卫生—肿瘤]

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