2μm激光联合吡柔比星膀胱灌注治疗浅表性膀胱癌(附96例报告)

2 μm continuous wave laser resection combined with intravesical instillation of pirarubicin for superficial bladder cancer:report of 96 cases

目的探讨经尿道2μm激光联合吡柔比星膀胱灌注治疗浅表性膀胱癌的疗效。方法回顾性分析96例浅表性膀胱癌患者的临床资料,其中82例为单发肿瘤,其余为多发,肿瘤直径0.5～3.5cm。采用经尿道2μm激光手术系统治疗,术后常规吡柔比星膀胱灌注化疗,定期行膀胱镜检查。结果手术均获成功,平均手术时间13(8～45)min。术中出血量极少,无闭孔神经反射及膀胱穿孔发生。随访92例,失访4例。平均随访时间13(5～29)个月。11例复发(11.5%)。2例术后尿道狭窄,定期扩张后治愈。结论经尿道2μm激光治疗浅表性膀胱癌出血量极少,并发症少,是一种安全有效的治疗方法 。

Objective To investigate the efficacy of transurethral 2 μm continuous wave laser resection combined with intravesical instillation of pirarubicin（THP）for superficial bladder cancer.MethodsA retrospectire study was performed on the clinical data of 96 patients with superficial bladder cancer.82 cases had single tumor and 14 had multiple tumors.The tumor diameter ranged from 0.5 to 3.5 cm.The superficial bladder cancer was successfully treated with 2 μm continuous wave laser resection via cystoscope.Postoperative intravesical chemotherapy with pirarubicin and cystoscopic surveillance were performed according to classic recommendation.ResultsAll cases underwent operations successfully.The mean operation time was 13（8-45）min.With few intraoperative bleeding,no obvious obturator nerve reflex nor bladder perforation were found in all patients.The 92 cases were followed up for 5 to 29 months with a mean of 13 months after treatment.11 patients（11.5%）had recurrence.Urethera stricture happened in 2 cases which was cured by dilation of urethra.Conclusions2 μm continuous wave laser resection via cystoscope for superficial bladder cancer is a safe and efficient method,with few bleeding and complication.