经尿道超脉冲等离子体双极电切术治疗膀胱移行细胞癌51例分析

Bipolar plasmakinetic superpulse transurethral resection of the bladder tumor in treatment of the non muscle-invasive bladder transitional cell carcinoma:a report of 51 cases

目的:探讨经尿道超脉冲等离子体双极电切术(PKSP+TURBt)治疗非肌层浸润性膀胱移行细胞癌的临床疗效。方法:51例非肌层浸润性膀胱移行细胞癌患者采用PKSP+TURBt行膀胱肿瘤电切术。结果:手术时间5～65min,平均17.9min,出血量少,无经尿道电切综合征;21例侧壁肿瘤切除时,11例发生闭孔神经反射,2例膀胱穿孔;肿瘤病理分期:TI S2例,Ta 7例,T142例;病理分级:G137例,G214例;随访10～59个月,20例复发,12例行PKSP+TURBt,4例改行根治术。结论:PKSP+TURBt是一种治疗非肌层浸润性膀胱移行细胞癌安全、有效的手术方式。

Objective： To evaluate the clinical efficacy and safety of the bipolar plasmakinetic superpulse transurethral resection of the bladder tumor（PKSP＋TURBt） in treatment of the non muscle-invasive bladder transitional cell carcinoma.Methods：A total of 51 cases with non muscle-invasive bladder transitional cell carcinoma were treated with PKSP＋TURBt by the Gyrus device.There were male 37 and female 14 between 34 and 82 years old（mean 58.3 years）.Results：The mean duration of the procedure was 17.9 min（5 to 65 min）with little bleeding.No TURS syndrome was found.The adductor reflex was found in 21 cases with tumor located at the lateral wall and bladder perforation occurred in 2 patients.All patients（according to pathology staging,37 of G1,14 of G2;according to TNM staging,2 of TIS,7 of Ta,42 of T1） were followed up for 10-59 months postoperatively.Relapse occurred in 20 cases.Second PKSP＋TURBt was conducted in 12 cases,4 cases received radical cystectomy.Conclusions：PKSP＋TURBt in treatment of the non muscle-invasive bladder transitional cell carcinoma is effective and safe.