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

Preliminary experience of needle-shaped electrode transurethral bladder tumor removal for bladder cancer

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。

Objective:To evaluate the safety and effectiveness of transurethral en bloc resection by needleshaped 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.