钬激光治疗膀胱癌

Treatment of Bladder Cancer with Ha YAG Laser

目的比较经尿道钬激光切除与经尿道电切治疗膀胱癌的疗效及安全性方法随机选取58例膀胱癌患者行经尿道钬激光切除，另42例行经尿道电切，总结两组患者临床资料。结果钬激光组手术时间10～60min，平均19min、术中无明显出血，无膀胱穿孔，无闭孔神经反射发生。术后留置尿管4～7天，平均5、4d。病理学均获得分期．随访2～24个月术后9个月复发5例，12个月复发2例，4例发生尿道狭窄。电切组手术时间15～55min，平均20min。发生闭孔神经反射11例，膀胱穿孔7例，术后7例需膀胱冲洗。导尿管留置时间4～10d，平均6．5d51例获得病理分期，随访3～24个月，5倒发生尿道狭窄，19例复发，其中5倒原位复发。两组手术时间、术后留置导尿管时间、术后尿道狭窄及获得肿瘤分期例数发生率比较，差异无统计学意义（均P〉0．05）。肿瘤复发率、膀胱穿孔例数、膀胱冲洗例数钬激光组显著少于电切组（P〈0．05）。结论钬激光是治疗膀胱癌有效、安全的方法。

Objective To compare the clinical efficacy and safety of hohnium laser resection and electrocautery transurethral resection for bladder tumors （TURBT）. Methods Fifty - eight cases were randomly assigned to undergo hohnium laser resection of bladder tumors （HOLRBT） , and Forty- two cases, standard eleetl＇O- eautery transurethral resection. The mean operative time, indwelling urethral catheter time, postoperative recurrences, the case number of obtaining tumor stages, and the numbers of postoperative bladder perfusion, bladder perforation and urethral stenosis were compared between the two groups. Results The mean operative time, indwelling urethral catheter time, incidences of urethral stenosis and postoperative tumor stages were not significantly different between the 2 groups （P 〉 0.05）. Compared with electrocautery resection group, less incidence of postoperative recurrence in HOLRBT group,less cases needed bladder perfusion and had bladder per- foration （P 〈 0.05）. Conclusion The HOLRBT technique is safe and effective for treatment of bladder cancer.