经尿道荧光膀胱镜下膀胱肿瘤整体切除术的临床观察

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摘要目的探讨经尿道荧光膀胱镜下膀胱肿瘤整体切除术治疗膀胱肿瘤的临床方法。方法选取2014年1月~2015年12月在徐州市中心医院诊治的40例膀胱肿瘤患者。采用骶管阻滞麻醉，共切除肿瘤45枚，其中单发肿瘤36例，肿瘤直径0.5~2 cm，均位于膀胱后壁或颈口位置。先荧光膀胱镜下观察膀胱内肿瘤大小及部位，再用等离子沿肿瘤近端切开膀胱壁全层达膀胱外脂肪，然后向远端全层切除，最后切除肿瘤远端完整切除肿瘤及其基底部膀胱全层。结果 40例患者均顺利完成手术，手术时间10~40 min，平均（23.95±8.39）min，术中出血量极少，术后无继发性出血，术后肿瘤病理分期T1期34例，T2期6例，术后随访12~24个月，平均（14.89±1.97）个月，无肿瘤复发。结论经尿道荧光膀胱镜下膀胱肿瘤整体切除术能完整切除肿瘤及肿瘤基底，并且荧光下可以对可疑膀胱壁进行预防性切除，手术效果确切。

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	周荣升1 郁全胜2 臧光辉1 庞昆1 周祥举1 贺厚光1 梁清1 韩从辉1▲

关键词 ：膀胱尿路上皮癌, 荧光膀胱镜, 膀胱肿瘤整体切除术, 临床观察

Abstract：Objective To investigate the clinical method of transurethral resection of bladder tumor with cystoscopy in the treatment of bladder tumor. Methods From January 2014 to December 2015, 40 patients with bladder cancer who were treated at Xuzhou Central Hospital were observed. All the patients were treated with sacral obstruction anesthesia. 45 cases of tumor were removed, including 36 cases of tumor were single tumor, and the tumor diameter was 0.5~2 cm, which were located in the posterior wall of the bladder or the location of the neck. Firstly, the tumor size and location of the bladder were observed by fluorescent cystoscopy. Then the bladder wall full of bladder fat was cut by the plasma along the tumor proximal, along the tumor in full-thickness resection, the final resection of the tumor distal complete resection of the tumor and its basal bladder full-thickness pathology. Results 40 patients were successfully completed operation, and the operation time was 10-40 min, the mean time was (23.95±8.39) min. The intraoperative blood loss was very few, and there was no secondary bleeding after operation. 34 cases were postoperative tumor stage T1 and 6 cases were postoperative tumor stage T2. Patients were followed up 12-24 months after operation, the mean time was (14.89±1.97) months, no tumor case was recurred. Conclusion Transurethral resection of bladder tumor under cystoscopy can completely remove the tumor and tumor base, which can prevent the removal of the suspected bladder wall under fluorescence, and the surgery effect is exact.

Key words： Bladder urothelial carcinoma Fluorescent cystoscopy Bladder tumor resection Clinical observation

基金资助:江苏省医学创新团队（CXTD-2016-48）。

通讯作者: ▲通讯作者

作者简介: 周荣升（1976.6-），男，硕士，副主任医师；研究方向：泌尿外科。

引用本文:

周荣升1 郁全胜2 臧光辉1 庞昆1 周祥举1 贺厚光1 梁清1 韩从辉1▲. 经尿道荧光膀胱镜下膀胱肿瘤整体切除术的临床观察[J]. 中国医药导报, 2017, 14(15): 80-82,89.
ZHOU Rongsheng1 YU Quansheng2 ZANG Guanghui1 PANG Kun1 ZHOU Xiangju1 HE Houguang1 LIANG Qing1 HAN Conghui1▲. Clinical observation of total resection of bladder tumor with transurethral fluoroscopy. 中国医药导报, 2017, 14(15): 80-82,89.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I15/80

[1] 李双辉，张志宏，徐勇，等.根治性经尿道膀胱肿瘤电切术加化疗治疗肌层浸润性膀胱癌的疗效分析[J].中华泌尿外科杂志，2012，33（3）：215-218.
[2] 那彦群.中国泌尿外科疾病诊断治疗指南手册：2014版[M].北京：人民卫生出版社，2014.
[3] 杨晓峰，王东文.经尿道膀胱肿瘤切除术手术方式的进展[J].中华腔镜泌尿外科杂志2014，8（3）：60-64.
[4] 赫捷, 陈万青. 2012中国肿瘤登记年报[M].北京：军事医学科学出版社，2012.
[5] Dobruch J，Daneshmand S，Fisch M，et al. Gender and bladder cancer：a collaborative review of etiology，biology，and outcomes [J]. Eur Urol，2016，69（2）：300-310.
[6] Chavan S，Bray F，Lortet TJ，et al. International variations in bladder cancer incidence and mortality [J]. Eur Urol，2014，66（1）：59-73.
[7] Babjuk M，Burger M，Zigeuner R，et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder：update 2013 [J]. Eur Urol，2008，54（2）：639-653.
[8] 刘杰昊，杨晓峰，王玮，等.人膀胱癌BIU-87细胞裸鼠皮下移植瘤模型的建立[J].国际泌尿系统杂志，2014，34（4）：465-468.
[9] Li HT，Duymich CE，Weisenberger DJ，et al. Genetic and epigenetic alterations in bladder cancer [J]. Int Neurourol J，2016，20（Suppl 2）：S84-S94.
[10] Babjuk M，Oosterlinck W，Sylvester R，et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder，the 2011 update [J]. Actas Urol Esp，2012，36（7）：389-402.
[11] Ieda T，Muto S，Shimizu F，et al. Development and validation of a novel recurrence risk stratification for initial non-muscle invasive bladder cancer in Asia [J]. EBio Med，2016，12（C）：98-104.
[12] Eifler JB，Scarpato KR，Clark PE. Management of noninvasive bladder cancers [J]. Curr Opin Oncol，2015，27（3）：185-190.
[13] Joudi FN，Konety BR. Fluorescence cystoscopy and bladder surveillance [J]. Curr Opin Urol，2004，14（5）：265-270.
[14] 李伟，张开颜，陈斌，等.窄带显像膀胱镜引导下经尿道膀胱肿瘤电切术降低膀胱肿瘤术后复发率[J].中国内镜杂志，2014，20（5）：531-535.
[15] Zaak D，Karl A，Stepp H，et al. Fluorescence cystoscopy at bladder cancer：present trials [J]. Urologe A，2007，46（11）：1519-1527.
[16] 王鹏，叶锦，张尧，等.荧光膀胱镜在血尿诊治中的应用评价（附58例报告）[J].中国美容医学，2012，21（z2）：101-102.
[17] 李海元，花晨朝.新型内镜成像技术在膀胱癌诊断中的应用进展[J].肿瘤防治研究，2016，43（5）：418-421.
[18] Jeon SS，Kang I，Hong J H，et al. Diagnostic efficacy of fluorescence cystoscopy for detection of urothelial neoplasms [J]. J Endourol，2001，15（7）：753-759.
[19] Grimbergen MC，Swol CF，Jonges TG，et al. Reduced spe-cificity of 5-ALA induced fluorescence in photodynamic diagnosis of transitional cell carcinoma after previous intravesical therapy [J]. Eur Urol，2003，44（1）：51-56.
[20] 马天加，王文振，姜兆群，等.NBI辅助钬激光与TURBt治疗非肌层浸润性膀胱尿路上皮癌的前瞻性随机对照研究[J].中华医学杂志，2015，95（37）：3032-3035.
[21] Tauber S，Schneede P，Liedl B，et al. Fluorescence cytology of the urinary bladder [J]. Urology，2003，61（5）：1067-1071.
[22] 郭和清，周高标，朱晓应，等. 5-ALA荧光膀胱镜的应用对非肌层浸润性膀胱癌早期复发率的影响[J].临床泌尿外科杂志，2011，26（6）：422-424.
[23] 郁华亮，杨勇，李建业，等. 经尿道2 μm激光膀胱部分切除术与经尿道膀胱肿瘤电切术治疗T1G3膀胱癌的疗效比较[J].解放军医学院学报，2015，36（3）：251-254.
[24] 贺大林，吴开杰，范晋海，等.肌层非浸润型膀胱肿瘤激光治疗的现状与展望[J].现代泌尿外科杂志，2015，20（6）：373-375.