PK-TURBT联合羟喜树碱治疗非肌层浸润性膀胱癌

Treatment of non muscle-invasive bladder cancer by plasmakinetic transurethral resection of bladder tumor combined with hydroxycamptothecine

目的探讨经尿道等离子双极膀胱肿瘤电切术(PK-TURBT)联合羟基喜树碱膀胱灌注治疗非肌层浸润性膀胱癌的临床疗效。方法 66例非肌层浸润性膀胱癌患者在硬腰麻醉或腰硬联合麻醉下行PK-TURBT,术后定期给予羟基喜树碱膀胱灌注治疗,每3个月复查泌尿系超声和膀胱镜1次。结果 66例均顺利完成手术,手术时间平均40 min。5例发生闭孔神经反射,无膀胱穿孔及电切综合征发生。术后随访6～32个月,7例复发,再次行PK-TURBT,术后病情稳定,随访至今未复发。结论 PK-TURBT联合羟基喜树碱术后膀胱灌注化疗治疗非肌层浸润性膀胱癌疗效确切,安全性好。

Objective To discuss the clinical efficacy of plasmakinetic transurethral resection of bladder tumor（PK-TURBT） combined with bladder irrigation by hydroxycamptothecine（HCPT） on non muscle-invasive bladder cancer.Methods Sixty six patients with non muscle-invasive bladder cancer underwent PK-TURBT under epidural anesthesia or combined spinal-epidural anesthesia.After the operation,they periodically received the bladder irrigation by HCPT and the reexamination by urinary systematic ultrasound and cystoscopy for once every 3 months.Results The operations were successfully performed in the 66 cases with the average operative time of 40 minutes.Obturator nerve reflex occurred in 5 cases,and there were no vesical perforation and TUR syndrome.In the follow-up for 6 to 32 months,there were 7 cases of recurrence which received the second-time PK-TURBT.After the operation,their conditions were stable and recurrence did not occurred again.Conclusion PK-TURBT combined with HCPT has good curative effects and is safe in the treatment of non muscle-invasive bladder cancer.