经peel-away鞘输尿管镜下铥激光治疗小儿膀胱尿路上皮癌1例并文献复习

Treatment of Bladder Urothelial Carcinoma in Children with Thulium Laser Under Peel-Away Sheath Ureteroscopy: A Case Report and Literature Review

目的报告经peel-away鞘输尿管镜下铥激光治疗小儿膀胱尿路上皮癌1例,并结合文献探讨儿童膀胱尿路上皮癌的诊治要点。方法回顾性分析赣南医学院第一附属医院泌尿外科2019年8月收治的1例膀胱尿路上皮癌患儿的临床资料。患儿确诊为膀胱肿瘤后,于全麻下行经peel-away鞘输尿管镜下铥激光膀胱肿瘤整块切除术,并随访其复发情况。结果患儿手术过程顺利,手术时间20 min,术中估计出血量约5 ml。术后病理诊断:膀胱低级别非肌层浸润性乳头状尿路上皮癌。术后定期膀胱灌注化疗,随访16个月,肿瘤无复发,尿道无狭窄。结论经peel-away鞘输尿管镜下铥激光治疗小儿膀胱低级别非肌层浸润性尿路上皮癌安全可行。

Objective Here,we report a case of bladder urothelial carcinoma in a child treated with thulium laser under peel away sheath ureteroscopy and explore the key aspects of diagnosis and treatment of bladder urothelial carcinoma in children.Methods The clinical data for a child with bladder urothelial carcinoma treated in the Department of Urology of the First Affiliated Hospital of Gannan Medical College in August 2019 were analyzed retrospectively.After the diagnosis of bladder urothelial carcinoma,the whole bladder tumor was resected through thulium laser under peer away sheath ureteroscopy after the patient was placed under general anesthesia.Recurrence was assessed in follow-up.Results The operation time was 20 minutes,and the estimated amount of bleeding was 5 ml.The postoperative pathological diagnosis was low grade non-muscular invasive papillary urothelial carcinoma of the bladder.Regular intravesical infusion chemotherapy was performed after the operation,and no tumor recurrence and or urethral stricture was found in the follow-up lasting 16 months.Conclusion Thulium laser under peel away sheath ureteroscopy is safe and feasible for the treatment of low-grade non-muscular invasive urothelial carcinoma of the bladder in children.