不同入路钬激光治疗表浅膀胱肿瘤

Holmium:YAG laser resection for superficial bladder tumor from transurethral or percutaneous transvesical approach(Report of 60 cases)

目的 :探讨不同入路钬激光 (Ho∶YAG)治疗表浅膀胱肿瘤 (SBC)的方法及疗效。方法 :采用钬激光经尿道及经皮入路共切除肿瘤 6 0例 ,肿瘤病理分级G1～G2 ,临床分期T1～T2 。结果 :手术均一次成功 ,无膀胱穿孔等并发症 ,激光手术时间 :6～ 38min ,平均 19min。平均出血量 <5ml,创面基底及创缘随机活检无肿瘤残留 ,术后均行丝裂霉素膀胱灌注。随访 3～ 2 4个月 ,平均 13个月 ,3例术后 6～ 8个月异位复发 ,复发率为 5 %。结论 :经尿道钬激光切除膀胱肿瘤简单易行 ,安全有效 ,对于无法经尿道途径得到满意治疗的SBC 。

Purpose:To investigate the value and methods of Ho:YAG laser in the treatment of superficial bladder tumors.Methods:Endoscopic holmium laser bladder tumor resection involving transurethral or percutaneous transvesical approach has been performed in 60 patients with superficial bladder tumors.Results:The procedure were performed successful in all cases with no complication. Random biopsies of the tumor base and incisal margin were negative. All patients had been followed up for 3 to 24 months with a mean of 13 months, Heterotopic recurrences presented in 3 patients.Conclusions:Endoscopic holmium laser resection of bladder tumor (HoLRBt) is an effective method with the advantages of simple procedure, precise resection and no serious complication.