直出绿激光膀胱肿瘤剜除术在非肌层浸润性膀胱癌中的应用及技术探讨(附光盘)

Front-firing green-light laser en bloc enucleation for non-muscle-invasive bladder cancer:application and technique analysis

治疗非肌层浸润性膀胱癌(non-muscle invasive bladder cancer,NMIBC)的首选方法是经尿道膀胱肿瘤电切除术(transurethral resection of bladder tumor,TURBT),然而其本身的不足也是导致肿瘤复发的原因之一。随着医疗技术及医疗器械的不断发展,激光作为新技术逐渐应用于泌尿外科手术,早期激光技术主要应用于良性前列腺增生及泌尿系结石的治疗,后来激光应用于膀胱肿瘤,是基于其在良性前列腺增生治疗中应用的一种尝试,早期激光治疗膀胱肿瘤主要是气化切除,术后无组织标本存留,影响术后病理学测定及准确的病理学分期。为此,我们将绿激光原有特性改良为直出端射,并评估了经尿道直出绿激光膀胱肿瘤剜除术(front-firing green-light laser en bloc enucleation of bladder tumors,FGLEBT)在NMIBC患者治疗中的有效性和安全性。本文重点阐述绿激光在NMIBC治疗方面的应用现状及剜除术相关技术简介。

The standard procedure for staging and treating non-muscle-invasive bladder cancer （NMIBC） is still transure-thral resection of the bladder tumor （TURBT） via a wire loop .However ,TURBT is associated with serious disadvantages that facilitate tumor recurrence .Recently with the continuous development of medical technology and equipment ,laser as a new technology is gradually applied in urological surgery .The early laser technology is mainly used in benign prostatic hyperplasia and the treatment of urinary stone ,then applied to bladder tumor which is based on treating experience on benign prostatic hy-perplasia .But early laser treatment of bladder tumor is mainly vaporization resection with no postoperative tissue samples , which hinder postoperative accurate pathological staging .In this regard ,the properties of a green-light laser were modified to be front-firing and the safety and efficacy of an en bloc enucleation technique（front-firing green-light laser en bloc enucleation of bladder tumors ,FGLEBT ） for treating patients with NMIBC were initially evaluated in our department .Application of green-light laser in the patients with NMIBC and its technology introduction are mainly demonstrated here .