经尿道微波组织内凝固治疗膀胱癌研究(附35例临床分析)

Transurethral microwave tissue coagulation therapy for carcinoma of urinary bladder: an analysis of 35 patients

目的探讨经尿道微波组织内凝固治疗膀胱移行上皮癌的可行性。方法通过微波对膀胱壁组织内辐射的凝固效应和形态学改变的研究，确定适合于临床应用的微波输出量。在此基础上，经尿道微波组织内凝固治疗３５例膀胱癌患者，并从辐射过的部位取组织做病理学检查。全部患者术后均用丝裂霉素Ｃ常规膀胱腔内化疗，并且长期随访，平均时间为５６个月。结果微波对膀胱癌细胞的杀伤有效率为１００％。经尿道微波组织内凝固治疗膀胱癌，其１，２，３，５年的复发率及无瘤期与经尿道电切或膀胱部分切除术效果相当。其中１９例（５４．３％）５年内无肿瘤复发。结论微波疗法方便、安全、有效，不仅可治疗浅表性膀胱癌。

Objective To study the reliability of transurethral microwave tissue coagulation therapy for transitional epithelial carcinoma of the urinary bladder. Methods The suitable microwave output was affirmed by studying its coagulation effect on pig and human bladder wall according to histo morphologic changes. Based on this study, transurethral microwave tissue coagulation of bladder cancer (TUMTCBC) was carried out in 35 patients with bladder carcinoma. Biopies were taken from the microwave irradiated sites after the procedure. All patients were given regular intravesical chemotherapy with mitomycin C after microwave treatment and were followed up for a mean of 56 months. Results The treatment was effective in all of the treated patints. The recurrence rate and the tumor free period in patients treated with TUMTCBC was comparable to those in patients treated with transurethral electric cauterization or partial cystectomy. In 19 cases (54. 3%), no recurrence of tumor was found in 5 years. Conclusion TUMTCBC is safe, effective and easy to perform. It may be used for the treatment of both superficial and invasive bladder carcinoma.