TURBt术中粘膜下注射的应用

Application of submucous injection in transurethral electroresection of bladder tumor

目的 了解膀胱肿瘤浸润深度以及避免闭孔神经反射和电切过深。方法 2 0 0 0年 10月～ 2 0 0 2年 3月18例拟行TURBt的患者在电切前以无菌水经膀胱镜于肿瘤基底部注射。结果 2例肿瘤不能浮起 ,改为开放手术 ;另 16例均顺利电切 ,无闭孔神经反射 ,术后常规灌注 ,随访 13月～ 3 0月 ,未见复发。结论 :术中粘膜下注射是判断浅表性膀胱肿瘤较为直观和可靠的方法 ;本法可避免闭孔神经反射和电切过深。

Objective To comprehend depth of infiltration of bladder tumer and to prevent reflection of obturator nerve and over-resection.Methods From october 2000 to march 2002,18 cases of superficial bladder tumor were injected by water of sterility before transurethral electroresection of bladder tumor.Results Because tumor can not float,2 cases were treated by partial cystectomy;16 cases were operated by transurethral electroresection of bladder tumor,reflection of obturator could not found operatively,recurrence and metastases could not found postoperatively during follow-up of 13 months to 30 months.Conclusions Submucous injection is direct and reliable method to judge superficial bladder tumor;this method can avoid reflection of obturator nerve and over-resection.