联合治疗膀胱表浅癌148例临床分析

Clinical Analysis of United Treatment in 148 Cases with Superficial Bladder Cancer

目的:探讨降低经尿道电切治疗表浅性膀胱癌术中闭孔反射、膀胱穿孔发生率的方法,观察丝裂霉素经尿道直接逆行灌注膀胱化疗的安全性。方法:采用经尿道等离子体双极电切术(PKRBT)代替传统单级电切术(TURBT)治疗表浅性膀胱癌,以降低闭孔反射、膀胱穿孔发生率;术后用丝裂霉素经尿道外口直接逆行灌注膀胱化疗法治疗膀胱表浅癌148例。结果:148例手术均顺利,平均手术时间15 min,平均出血量<15 mL。术中发生轻度闭孔反射12例次,发生率为8.4%,无膀胱穿孔中转手术病例。结论:PKRBT代替传统TURBT,可有效降低闭孔反射、膀胱穿孔发生率,可提高手术安全性及成功率;丝裂霉素经尿道直接逆行灌注膀胱化疗是安全可行的。

Objective:To investigate the methods of decreasing the incidence of obturator reflex and bladder perforation by transurethral resection on superficial bladder tumor;To investigate the safety of intravesical instillation chemotherapy with Mitomycin C.Methods:We used transurethral plasmakinetic resection of superficial bladder tumor(PKRBT) in substitution for transurethral resection of bladder tumor(TURBT) in order to decrease the incidence of obturator reflex and bladder perforation;148 patients underwent intravesical instillation chemotherapy with Mitomycin C for superficial bladder tumor after TURBT.Results:All 148 cases of surgery were successful,lasting 15 min on average,and the average quantity of bleeding were below 15 mL.12 cases of mild obturator reflex occurred in the surgery,the incidence was 8.4%.No bladder perforation was found,no any cases changed into surgery.Conclusion:Using PKRBT in substitution for TURBT can effectively decrease the incidence of obturator reflex and bladder perforation,and increase safety and success rate;Intravesical instillation chemotherapy with Mitomycin C is safe and practicable.