经尿道等离子体双极电切术治疗非肌层浸润膀胱肿瘤疗效分析

Transurethral plasma kinetic resection of superficial bladder tumor

目的评估经尿道等离子体双极电切术(PKRBt)治疗膀胱肿瘤的有效性和安全性。方法回顾2005年4月至2007年6月完成的经尿道PKRBt手术者30例,男26例,女4例。年龄36～93岁,平均65岁。左侧壁11例,右侧壁13例,三角区及其他部位6例。肿瘤大小0.5～3.1cm。手术在硬膜外或腰麻下进行,分三段切除肿瘤送病理检查。结果所有肿瘤均顺利切除,手术时间15～75min,平均手术时间为40min。无输血病例。2例手术在切除小块组织时出现膀胱穿孔,留置尿管治愈;3例侧壁肿瘤手术时有轻微闭孔内肌反射。2例术前外院病理诊断腺性膀胱炎,术后病理诊断为尿路上皮癌。随访3～26个月,6例复发,5例再次行PKRBt术,1例行根治性切除术。结论经尿道等离子体双极电切是治疗浅表膀胱肿瘤的有效方法之一,切除侧壁肿瘤及小块组织时仍要特别小心。

Objective To evaluate the efficacy and safety of transurethral plasma kinetic resection of bladder tumor （PKRBt）. Methods The data of 30 cases undergoing PKRBt procedures between April 2005 and June 2007 were reviewed retrospectively. There were 26 males and 4 females, aged between 36 and 93 years with on average of 65 years. Eleven tumors were located at the left wall,13 at the right wall,other 6 at triangle region and other sites. Tumor size was 0.5-3.1 cm. Results All tumors were successfully removed by transurethral PKRBt procedures. Operation time was 15-75 minutes, with an average of 40 minutes. No patient needed transfusion. Bladder perforation occurred and was cured by catheterization in 2 cases. The internal obturator muscle reflex was found in three cases. All patients were followed up for 3-26 months. Tumor recurrence was found in 6 patients, of whom ,5 received PKRBt procedures again and the other one received radical cystectomy. Conclusion Transurethral PKRBt is effective and safe in treating superficial bladder tumors and should be done cautiously in resecting side wall tumors and small piece of tissue.