经尿道膀胱肿瘤电切联合吡柔比星灌注治疗浅表性膀胱癌疗效观察

Efficacy of Transurethral Resection of Bladder Tumor Combined with Pirarubicin Perfusion

[目的]探讨经尿道等离子膀胱肿瘤电切术（TURBT） 联合吡柔比星灌注治疗浅表性膀胱癌的安全性与有效性.[方法]用经尿道等离子体双极电切系统膀胱肿瘤电切（transurethral resection of the bladder tumor,TURBT）治疗膀胱癌90例,肿瘤分级G1为72例,G2为18例.电极切除肿瘤直达深肌层,同时扩大到电切距肿瘤基底1 cm范围的正常组织,术后定期进行膀胱内灌注吡柔比星化疗.[结果]手术时间5～46 min,平均（14±12） min.术中无经尿道电切综合征,发生闭孔神经反射11例,其中腹膜外穿孔1例.随访3～24 个月,8例复发,7例再行TURBT,1例并发尿道移形上皮癌,并行全尿道切除术,术后追踪观察至今未复发.[结论]TURBT联合吡柔比星膀胱灌注是治疗浅表性膀胱癌是的一种理想方法,疗效好,创伤小,副反应低,值得推广应用.

[Objective]To explore the safety and effectiveness of transurethral resection of bladder tumor （TURBT） combined with pirarubicin perfusion for the treatment of superficial bladder cancer. [Methods] Totally 90 cases of bladder cancer including 72 cases with grade G1 and 18 cases with grade （32 were treated with TURBT by using transurethral bipolar plasma system. Electrode resection reached to the deep muscle layer and extended to normal tissues at lcm around tumor basement. After operation, all patients were given regular bladder perfusion chemotherapy with pirarubicin. [Results]The operation time ranged from 5 to 46min with a mean of （14± 12）min. No intraoperative transurethral resection syndrome occurred. Obturator nerve reflex occurred in 11 cases including one case of extraperitoneal perforation. All patients were followed up for 3-24 months. Eight cases relapsed in which 7 cases underwent TURBT again and one case complicated with urethral transitional epithelial cancer underwent total ureth- rectomy. During the follow up to now, none of these 8 cases recurred. [Conclusion] TURBT combined with piraru- bicin bladder perfusion for the treatment of superficial bladder cancer is an ideal method with good efficacy, small trauma.and low side effects, so it is worthy of clinical promotion.