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)

Transurethral partial cystectomy by needle electrode during resection of urothelial bladder carcinoma(4 cases)

目的:探讨经尿道针状电极行膀胱部分切除术治疗膀胱肿瘤的可行性及临床效果.方法:采用硬膜外麻醉,经尿道等离子针状电极行膀胱部分切除术治疗4例膀胱肿瘤患者,肿瘤直径1～4 cm.用针状电极沿肿瘤周围环形全层切开膀胱壁,在肌层与结缔组织之间剥离整块膀胱壁,完整切除肿瘤所在部位膀胱全层标本送病理检查.观察手术时间、术中出血、术中及术后并发症、肿瘤病理分期.结果:4例患者共切除8枚肿瘤,每枚肿瘤切除时间4～30 min,平均(14.4±11.9) min;术中出血量极少或几乎不出血,无尿外渗,术后无继发出血.术后肿瘤病理分期:T1期3枚,T2a期4枚,T2b期1枚.结论:针状电极能安全有效地应用于膀胱肿瘤电切,并实现经尿道膀胱部分切除的效果.

Objective:To investigate the application and clinical effect of needle electrode in transurethral partial cystectomy.Methods:4patients with 8bladder tumors underwent transurethral partial cystectomy by needle electrode under epidural anesthesia.Tumor diameters range from 1to 4cm.A circular incision was made by the needle electrode through the full thickness of the bladder wall adjacent to the tumor,then the tumor as well as its basement was dissected between the plane of muscular layer and the connective tissue.The specimen containing the tumor and full thickness of the bladder wall was sent for pathology inspection.The operation time,blood loss,peri-operative complications,and pathologic stage of the tumor were observed.Results:8bladder tumors in 4patients were resected with the operative time of 4-30min per tumor,range(14.4±11.9)min.Blood loss during operation was minimal. Neither urinary extravasation nor post-operative bleeding occurred.The pathologic stage of the tumors resected includes 3in T1,4in T2a,and 1in T2b.Conclusions:The needle electrode can be applied safely and effectively during transurethral partial cystectomy.