针状电极经尿道膀胱肿瘤整块剜除术治疗膀胱癌初步经验

doi:10.19558/j.cnki.10-1020/r.2020.04.008

摘要
图/表
参考文献(18)
相关文章 (15)

全文: PDF (1685 KB) RICH HTML
输出: BibTeX | EndNote (RIS)

摘要 目的: 评估双极针状电极经尿道膀胱肿瘤整块剜除的安全性和有效性。方法: 2016年1月–2019年1月,34例新诊断为膀胱癌的患者接受双极针状电极经尿道膀胱肿瘤整块剜除术,记录手术过程,分析病理结果以及术中和术后并发症发生率。结果: 34例患者共切除66个肿瘤,肿瘤直径平均（1.9±1.01）cm,平均手术时间（57.6±22.2）min,平均术中出血（24.9±18.7）mL,术中发生闭孔反射1例,未发生膀胱穿孔。病理分期≤T₁者20例(58.8%),T₂者14例(41.2%);病理分级: 低度恶性潜能1例（2.9%）,低级别22例（64.7%）,高级别11例（32.4%）。随访7~41个月,病例分期≤T₁和T₂患者的7个月复发率分别为15%（3/20）和35.7%（5/14）,2例T₂期患者发生肿瘤进展,≤T₁期患者未发生肿瘤进展。结论: 双极针状电极经尿道膀胱肿瘤剜除术是一种有效、可行、安全的膀胱癌治疗方法。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	李佳朔
	尚攀峰
	尚义超
	郑旭

关键词 ：膀胱癌, 剜除, 针状电极

Abstract：Objective: To evaluate the safety and effectiveness of transurethral en bloc resection by needle-shaped plasmakinetic electrode for the treatment of bladder tumor. Methods: From January 2016 to January 2019, 34 patients with newly diagnosed bladder cancer were treated with transurethral en bloc resection by needle-shaped plasmakinetic electrode. The operation process was recorded, and the pathological results and the incidence of intraoperative and postoperative complications were analyzed. Results: A total of 66 tumors were removed from 34 patients, and the average tumor diameter was (1.9±1.0) cm. The average operation time was (57.6±22.2) min. The average intraoperative hemorrhage was (24.9±18.7) mL. One case had obturator reflex and no bladder perforation occurred. Pathological assessment showed pathological stage ≤ T₁ in 20 cases (58.8%), T₂ in 14 cases (41.2%). For the pathological grade, there was one case of low-grade malignant potential (2.9%), 22 cases of low-grade (64.7%), and 11 cases of high-grade (32.4%). All patients were followed up for 7-41 months. The 7-month recurrence rate of patients with stage ≤T₁ and T₂ was 15% (3/20) and 35.7% (5/14), respectively. Two patients with T2 had tumor progression, and no patients with ≤T₁ had tumor progression. Conclusion: The transurethral en bloc resection by needle-shaped plasmakinetic electrode for the treatment of bladder tumor is an effective, feasible and safe treatment for bladder cancer.

Key words： bladder tumor removal needle-shaped electrode

收稿日期: 2019-11-12

基金资助:甘肃省重点研发项目（17YF1FA12）

通讯作者: 尚攀峰,shangpf@lzu.edu.cn

引用本文:

李佳朔, 尚攀峰, 尚义超, 郑旭. 针状电极经尿道膀胱肿瘤整块剜除术治疗膀胱癌初步经验[J]. 微创泌尿外科杂志, 2020, 9(4): 250-254.
LI Jiashuo, SHANG Panfeng, SHANG Yichao, ZHENG Xu. Preliminary experience of needle-shaped electrode transurethral bladder tumor removal for bladder cancer. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(4): 250-254.

链接本文:

http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1608.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I4/250

[1] BABJUK M, BÖHLE A, BURGER M, et al. EAU guidelines on Non-Muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol, 2017,71(3):447-461.
[2] CHANG SS, BOORJIAN SA, CHOU R, et al. Diagnosis and treatment of Non-Muscle invasive bladder cancer: AUA/SUO guideline. J Urol, 2016,196(4):1021-1029.
[3] NASELLI A, PUPPO P. En bloc transurethral resection of bladder tumors: a new standard? J Endourol, 2017,31(S1):S20-S24.
[4] FRITSCHE HM, OTTO W, EDER F, et al. Water-jet-aided transurethral dissection of urothelial carcinoma: a prospective clinical study. J Endourol, 2011,25(10):1599-1603.
[5] SONG XS, YANG DY, CHE XY, et al. Comparing the safety and efficiency of conventional monopolar, plasmakinetic, and Holmium laser transurethral resection of primary non-muscle invasive bladder cancer. J Endourol, 2010,24(1):69-73.
[6] SOBIN LH, GOSPODAROWICZ MK, WITTEKIND C, et al. TNM Classification of Malignant Tumours, 7th Edition. Chichester: Wiley Blackwell, 2009:262-265.
[7] EBLE J, SAUTER G, EPSTEIN J, et al. Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. J Urol, 2004,172(6):2511.
[8] 贾毅,李守宾,刘俊江,等.经尿道针状电极膀胱肿瘤整块切除术降低非肌层浸润性膀胱癌术后复发率的研究.微创泌尿外科杂志,2020,9(2):110-114.
[9] HURLE R, LAZZERI M, COLOMBO P, et al. "En bloc" resection of nonmuscle invasive bladder cancer: a prospective single-center study. Urology, 2016,90(90):126-130.
[10] ZHANG JF, WANG LS, MAO SY, et al. Transurethral en bloc resection with bipolar button electrode for non-muscle invasive bladder cancer. Int Urol Nephrol, 2018,50(4):619-623.
[11] HARRY WH, DONAT SM. Quality control in transurethral resection of bladder tumours. BJU Int, 2008,102(9b):1242-1246.
[12] EL-ACHKAR A, SOUHAMI L, KASSOUF W. Bladder preservation therapy: review of literature and future directions of trimodal therapy. Curr Urol Rep, 2018,19(12):108.
[13] ZHONG J, SWITCHENKO J, JEGADEESH NK, et al. Comparison of outcomes in patients with muscle-invasive bladder cancer treated with radical cystectomy versus bladder preservation. Am J Clin Oncol, 2019,42(1):36-41.
[14] CUMBERBATCH MGK, FOERSTER B, CATTO JWF, et al. Repeat transurethral resection in non-muscle-invasive bladder cancer: a systematic review. Eur Urol, 2018,73(6):925-933.
[15] ZHUO L, LI YW, QIANG L, et al. Value of repeat radical transurethral resection for selected patients with muscle-invasive bladder cancer. ANZ J Surg, 2018,88(10):1033-1036.
[16] BACH T, MUSCHTER R, HERRMANN TW, et al. Technical solutions to improve the management of non-muscle-invasive transitional cell carcinoma: summary of a European Association of Urology Section for Uro-Technology (ESUT) and Section for Uro-Oncology (ESOU) expert meeting and current and future pers. BJU Int, 2015,115(1):14-23.
[17] MATTHEW JM, VRICELLA GJ, MACLENNAN G, et al. Endoscopic snare resection of bladder tumors: evaluation of an alternative technique for bladder tumor resection. J Endourol, 2012,26(6):614-617.
[18] HAYASHIDA Y, MIYATA Y, MATSUO T, et al. A pilot study to assess the safety and usefulness of combined transurethral endoscopic mucosal resection and en-bloc resection for non-muscle invasive bladder cancer. BMC Urol, 2019,19(1):56.