腔内钬激光联合丝裂霉素灌注化疗治疗浅表性膀胱肿瘤临床体会

Clinical experiences of holmium laser with Mitomycin irrigation chemotherapy for bladder neoplasm

目的:探讨腔内钬激光(Ho:YAG)联合丝裂霉素灌注化疗治疗膀胱浅表性肿瘤的疗效及安全性。方法:回顾性分析应用钬激光骶麻下治疗膀胱肿瘤患者56例,其中50例膀胱浅表性移行细胞癌,6例腺性膀胱炎。结果:56例膀胱肿瘤均一次切除,平均手术时间50min。术中肿瘤切至浅肌层,无大出血,闭孔神经反射及膀胱穿孔者。术后当天膀胱灌注化疗,平均留置双腔或三腔导尿管2～3d,术后3个月复查膀胱镜见肿瘤消失、膀胱黏膜修复完整;治疗效果满意。随访3～36个月,3例复发及新生病例。结论:腔内钬激光联合丝裂霉素灌注化疗治疗浅表性膀胱肿瘤是一种安全、微创、出血量极少的治疗方法,疗效显著,并发症少.

Objective To discuss the curative effect and the security of holmium laser （Ho： YAG） with Mitomycin irrigation chemotherapy treating urinary bladder neoplasm.Method The review analyzed my courtyard to apply under the holmium laser to treat the bladder neoplasm in 56 cases,50 cases of urinary bladder transitional cell cancer and 6 cases of gland cystitis.Results For 56 cases of bladder neoplasm got homogeneous excision,the average surgery time was 50 min.In the operation,the tumor cutted to the light myo-level,did not have the massive hemorrhage,the nervous obturatorius reflection and the urinary bladder puncher.After the operation,the same day did urinary bladder irrigation chemotherapy,the average leaving alone pair or three cavity catheter 2 ～ 3 days,3 months later,reexamined cystoscope saw tumor vanishing,the urinary bladder mucous membrane repair to be completed.The treatment results was satisfied.Making a follow-up visit for 3 ～ 36 months,3 cases of recrudescences and new onset.Conclusion Holmium laser with Mitomycin irrigation chemotherapy treating the bladder neoplasm is one kind of security,microtrauma,little blood loss treatment,the curative effect is remarkable,the complications are fewer.