激光和等离子技术在经尿道膀胱肿瘤整块切除术中的应用进展

Application of laser and plasma technique in en bloc resection of bladder tumor

随着激光和等离子技术的不断发展,经尿道膀胱肿瘤整块切除术变得更安全可行,又因其符合无瘤原则以及有助于术后标本病理的分期分级,有望成为治疗非肌层浸润性膀胱癌的新标准。目前临床上最常用的设备是激光与等离子,且我国医师对其研究处于国际领先水平,其中激光(尤其是钬激光与铥激光)在切割、止血以及减少并发症方面具有较大的优势,而等离子虽不能完全消除但能大大减少闭孔神经反射的发生,且在处理特殊角度的肿瘤时,具有独特的优势,可以考虑在基层医院进行尝试与推广。本文对激光与等离子的特性和临床实际应用情况做简单综述,为临床医生开展膀胱肿瘤整块切除术提供一定的参考。

With the development of laser and plasma technology, en bloc resection of bladder tumors has become safer and more feasible, and it is expected to become the new standard for the treatment of non-muscle invasive bladder cancer because it conforms to the principle of no tumor and contributes to the staging of postoperative specimen pathology. Currently, the most common equipment used clinically is laser and plasma, and the research in China is in the leading level. Laser(especially holmium laser and thulium laser) has great advantages in cutting, stopping bleeding and reducing the complications. The plasma even cannot completely eliminate but can greatly reduce the occurrence of obturator nerve reflex, and it has a unique advantage in dealing with some special angles of the tumor. Thus, it can be tried and promoted in basic-level hospitals. In this paper, we briefly reviewed the characteristics of laser and plasma and their clinical application, which will provide some reference for clinicians to carry out en bloc resection of bladder tumor.