经尿道针状电极膀胱部分切除术治疗膀胱癌的初步经验
宋伟宁1,2 ,徐阿祥1 ,孙圣坤1 ,许勇1 ,杨国强1 ,杜科霖2 ,张旭1
1 中国人民解放军总医院泌尿外科 100853 北京2 山东省潍坊市第二人民医院泌尿外科
Initial experiences of transurethral partial cystectomy by needle shape electrode in the treatment of bladder cancer
Song Weining1,2 ,Xu Axiang1 ,Sun Shengkun1 ,Xu Yong1 ,Yang Guoqiang1 ,Du Kelin2 ,Zhang Xu1
1 Department of Urology, Chinese PLA General Hospital, Beijing 100853, China;2 Department of Urology, Second People's Hospital of Weifang
摘要 目的: 对经尿道针状电极行膀胱部分切除术治疗膀胱肿瘤的初步经验进行总结。方法: 应用等离子针状电极对8例膀胱肿瘤患者进行经尿道膀胱部分切除术,观察术中及术后并发症,术后病理分期,总结手术操作经验。结果: 所有患者在硬膜外麻醉下均可耐受手术,术中出血量极少或几乎无出血,无尿外渗,闭孔神经反射可控。术后无继发出血及尿路刺激症状。获得完整肿瘤病理分期:T1 期5枚, T2a 期5枚,T2b 期2枚。随访2~3个月,患者无不适。结论: 等离子针状电极能安全有效地应用于经尿道膀胱部分切除术。
关键词 :
膀胱肿瘤 ,
等离子针状电极 ,
膀胱部分切除术 ,
闭孔神经反射
Abstract :Objective: To investigate the application and clinical effect of needle electrode during transurethral partial cystectomy. Methods: Eight patients with 12 bladder tumors received transurethral partial cystectomy by needle electrode. The peri-operative complications, and pathologic stage of the tumor were observed. The surgical techniques were summarized. Results: All patients received operation under epidural anesthesia with minimal blood loss and without urinary extravasation. There was no unexpected obturator nerve reflection. Neither secondary blood loss nor urinary irritation symptoms occurred post-operation. The pathologic stage of the tumors resected included T1 in 5 cases, T2a in 5 cases, and T2b in 2 cases. Conclusions: The needle electrode can be applied safely and effectively during transurethral partial cystectomy.
Key words :
bladder tumor
plasmakinetic needle shape electrode
partial cystectomy
obturator nerve reflex
收稿日期: 2014-03-18
基金资助: 卫生部行业基金子课题(201002010)
通讯作者:
徐阿祥,xuaxiang301@sina.com;孙圣坤,saintkuns@gmail.com
引用本文:
宋伟宁,徐阿祥,孙圣坤,许勇,杨国强,杜科霖,张旭. 经尿道针状电极膀胱部分切除术治疗膀胱癌的初步经验[J]. 微创泌尿外科杂志, 2014, 3(2): 108-111.
Song Weining,Xu Axiang,Sun Shengkun,Xu Yong,Yang Guoqiang,Du Kelin,Zhang Xu. Initial experiences of transurethral partial cystectomy by needle shape electrode in the treatment of bladder cancer. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2014, 3(2): 108-111.
链接本文:
http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract924.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2014/V3/I2/108
[1]宋伟宁, 徐阿祥, 孙圣坤,等.经尿道针状电极膀胱部分切除术治疗膀胱尿路上皮癌(附4例报告).微创泌尿外科杂志, 2013, 2(6): 396-398. [2]那彦群, 叶章群,孙光.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社, 2011. [3]Walsh PC. Campbell's Urology. 10th ed. Philadephia: WB Saunders, 2002:2331. [4]杨勇,魏志涛,张旭,等.经尿道2 μm激光膀胱部分切除术治疗膀胱肿瘤的初步探讨.中华外科杂志,2009,47(2):143-145. [5]Yang Y, Wei ZT, Zhang X, et al. Transurethral partial cystectomy with continuous wave laser for bladder carcinoma. J Urol, 2009,182(1):66-69. [6]李辉华,陈宁,邓助朋,等.经尿道电切术与等离子切除术治疗膀胱肿瘤的疗效对比.中国老年学杂志,2012,32(16):3556-3557. [7]Akkaya T, Comert A, Kendir S, et al. Detailed anatomy of accessory obturator nerve blockade. Minerva Anestesiol, 2008,74(4):119-122. [8]Shankar H. Ultrasound-guided steroid injection for obturator neuralgia. Pain Pract, 2008, 8(4):320-323. [9]Moningi S, Durga P, Ramachandran G, et al. Comparison of inguinal versus classic approach for obturator nerve block in patients undergoing transurethral resection of bladder tumors under spinal anesthesia. J Anaesthesiol Clin Pharmacol, 2014,30(1): 41-45. [10]Manassero A, Bossolasco M, Ugues S, et al. Ultrasound-guided obturator nerve block interfascial injection versus a neurostimulation-assisted technique. Reg Anesth Pain Med, 2012, 37(1):67-71. [11]孙圣坤,宋兵,宋勇,等.超声引导闭孔神经阻滞在膀胱肿瘤电切中的应用.微创泌尿外科杂志,2013,2(1):76-78.
[1]
王伟, 周红庆, 刘明生, 邵涛. 经尿道膀胱肿瘤等离子整块剜除术与传统电切术的对比研究 [J]. 微创泌尿外科杂志, 2020, 9(2): 115-119.
[2]
贾毅, 李守宾, 刘俊江, 郭留雄, 孙福振, 魏东, 谷守义, 王刚, 张盼英, 李静坡. 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 [J]. 微创泌尿外科杂志, 2020, 9(2): 110-114.
[3]
孙圣坤, 单立松, 许勇, 符伟军, 张旭. 气膀胱精准经尿道膀胱肿瘤切除术 [J]. 微创泌尿外科杂志, 2019, 8(6): 361-364.
[4]
叶金汉, 陈艺林, 李坤, 周泽光, 廖春华, 刘成倍. 经尿道铥激光整块切除与等离子电切治疗膀胱肿瘤的疗效对比分析 [J]. 微创泌尿外科杂志, 2019, 8(3): 168-172.
[5]
戴强,季惠翔,陈志文,周占松. 2微米激光膀胱肿瘤诊断性切除术61例分析 [J]. 微创泌尿外科杂志, 2018, 7(s1): 23-.
[6]
郝保良,孙圣坤,彭亮,张鹏,杨国强,许勇,徐阿祥,张磊,陈光富,符伟军,张旭. 精准经尿道膀胱肿瘤切除治疗膀胱侧壁肿瘤的临床研究 [J]. 微创泌尿外科杂志, 2018, 7(s1): 22-.
[7]
魏志涛,孙东翀,杨勇,许勇. 经尿道2 μm激光膀胱部分切除术后膀胱内液体外渗的临床观察研究 [J]. 微创泌尿外科杂志, 2018, 7(s1): 24-.
[8]
宋伟宁, 徐阿祥, 孙圣坤, 杨国强, 许勇, 杜国防, 徐真蕊, 张旭. 经尿道针状电极膀胱部分切除术治疗膀胱尿路上皮癌(附4例报告) [J]. 微创泌尿外科杂志, 2018, 7(s1): 21-.
[9]
丁友鹏, 王志新, 马亚南, 魏鑫, 侯毅, 孔祥波. 经尿道双极等离子针状电极与环状电极治疗非肌层浸润性膀胱癌的疗效对比分析 [J]. 微创泌尿外科杂志, 2018, 7(6): 410-413.
[10]
林晨, 刘湘鄂, 向俊, 乔亮, 赵明启. 吡柔比星膀胱灌注对浅表性膀胱癌患者血清sICAM-1、VEGF及MMP-9水平的影响 [J]. 微创泌尿外科杂志, 2018, 7(5): 346-350.
[11]
朱俊成, 李炯明, 刘建和, 刘开明, 姜永明, 方克伟, 王光, 李沛, 石鑫, Prashant, 段飞. 腹腔镜下根治性膀胱切除术中髂外血管淋巴结转移侵犯的处理 [J]. 微创泌尿外科杂志, 2018, 7(3): 166-169.
[12]
杨荣权, 廖泽明, 蔡勇. 1 470 nm半导体激光联合阿帕奇醌膀胱灌注治疗浅表性膀胱肿瘤的疗效评价 [J]. 微创泌尿外科杂志, 2018, 7(3): 192-195.
[13]
袁谦, 张凌, 汪青蓉, 肖克峰. 窄带光谱成像膀胱软镜与白光膀胱硬镜在非肌层浸润性膀胱癌术后随访中的应用比较 [J]. 微创泌尿外科杂志, 2018, 7(3): 188-191.
[14]
成海生, 闫永吉, 高文锋, 张韬, 贺宏波, 张雪松, 仰景荣. 特殊情况下的输尿管支架管置入术与文献复习 [J]. 微创泌尿外科杂志, 2018, 7(1): 26-29.
[15]
王云汉, 李响. 窄带成像技术膀胱镜与普通白光膀胱镜诊疗非肌层浸润性膀胱肿瘤价值的meta分析 [J]. 微创泌尿外科杂志, 2017, 6(4): 224-229.