Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor

Objective： To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor （TURBT）. Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0. 75% pure bupivacaine （8-12 rag） was applied to patients in Group Ⅰ （n= 30）. Patients in Group Ⅱ （n=30） received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil ; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results ： The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ . Obturator nerve reflex was observed in 15 （50. 0%） patients in Group Ⅰ , but none （0%） in Group Ⅱ （P〈0. 01）. Conclusion.. Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.

Intravesical explosion during transurethral resection of bladder tumor:A case report

BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a potential threat to the patient’s life.CASE SUMMARY This paper reports a case of intravesical explosion during TUR-BT.Combined with the literature review,the risk factors are analyzed and measures of prevention and treatment are discussed.CONCLUSION Although rare,intravesical explosions can cause serious consequences,and the loud explosion can also lead to a profound psychological shadow on the patient.Urologists must be aware of this potential complication.Careful operative techniques and special precautions can reduce the risk of this complication.

Transurethral Resection of Bladder Tumours: Results and Outcomes

Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at a urology center in Douala, Cameroon. Patients and Methods: This was a retrospective study carried out from 2015 to 2019 on 32 patients with bladder tumors that were managed at the Centre medico-chirugical d’urologie in Douala, Cameroon. The relevant data were obtained from patients’ clinical records. Results: A total of 32 patients (25 men and 7 women) aged 29 - 75 years were included in this study. The mean age of the study participants was 58.63 ± 11.00 years. Among our study participants, there were 10 smokers (31.25%). Eight (25%) of them had occupational exposure while 2 (6.25%) had residential exposure to bladder cancer. Thirty (93.75%) presented with hematuria, 2 (6.25%) presented with recurrent urinary tract infections, and 1 (3.13%) presented with acute urinary colic. Nineteen (59.38%) of them were anemic, with 4 (12.5%) requiring blood transfusions. Twenty-seven (84.38%) of them had pedunculated tumors while 5 (15.62%) had sessile tumors. The tumor diameters ranged from 1 cm to 5 cm, with a mean diameter of 2.75 ± 1.22 cm. Complete resection was performed in 27 (84.38%) participants while partial resection was performed in 5 (15.62%) patients. The early single instillation of intravesical chemotherapy with mitomycin was performed in 8 (25%) patients. Only one (3.13%) patient had a postoperative complication, and seven (21.88%) patients experienced tumor recurrence and underwent a second TURBT. Two (6.25%) of the 32 patients died and 30 (93.75%) survived. Conclusion: TURBT is the gold standard method of managing bladder tumors. This procedure is at the same time diagnostic and therapeutic for tumors that do not invade the walls of the urinary bladder.

新辅助放疗联合cTURBT和辅助化疗治疗直径≥3cm的T_(2)期MIBC的疗效与安全性

目的探讨新辅助调强适形放疗联合“最大化”经尿道膀胱肿瘤电切术(cTURBT)和辅助化疗治疗肿瘤直径≥3 cm的T 2期肌层浸润性膀胱癌(MIBC)的疗效与安全性。方法回顾性分析天津市人民医院泌尿外科收治的接受新辅助放疗联合cTURBT和辅助化疗的31例病灶直径≥3 cm的T 2期MIBC患者的临床资料,随访患者复发、转移、生存、死亡情况。结果31例患者均接受新辅助放疗,放疗总剂量为48(44,50)Gy,放疗后3例(9.7%)完全缓解,19例(61.3%)部分缓解,客观缓解率为71.0%,疾病控制率为96.8%。所有患者顺利行cTURBT术,手术时间37(31,42)min,出血量为20(10,30)ml,无围手术期输血患者,术后住院时间为4(4,5)d,术中无闭孔神经损伤、膀胱穿孔、严重出血、经尿道电切综合征发生。随访患者12~36个月,9例(29.0%)患者复发,中位复发时间18(10,23.5)个月,6例患者为膀胱内复发,其中5例再次行cTURBT术联合膀胱灌注治疗,1例行挽救性根治性膀胱切除术(RC);2例出现膀胱内复发和淋巴结转移,其中1例行cTURBT联合免疫治疗,1例行挽救性RC;1例出现全身多发转移,行姑息性治疗。结论新辅助放疗联合cTURBT和辅助化疗治疗直径≥3 cm的T 2期MIBC患者,保膀胱成功率高,可作为不能或不愿接受RC患者的保膀胱治疗策略。

同期与分期TURBT/PKRP手术对膀胱癌合并前列腺增生患者疗效对比

目的分析同期与分期经尿道膀胱肿瘤切除术(TURBT)/经尿道前列腺等离子电切术(PKRP)对膀胱癌合并前列腺增生患者术后恢复的影响。方法选取2020年12月至2023年12月山西省肿瘤医院膀胱癌合并前列腺增生患者98例,其中同期行TURBT术与PKRP术治疗者52例纳入同期组,分期行TURBT术与PKRP术治疗者46例纳入分期组。比较两组疗效;前列腺功能指标[最大尿流率(Qmax)、残余尿量(RU)、国际前列腺症状(IPSS)评分、最大尿道闭合压、最大尿道压]、预后(膀胱癌复发、前列腺窝种植转移情况)。结果同期组疗效优于分期组;相较于术前,术后6个月两组Qmax均升高,RU、IPSS评分、最大尿道闭合压、最大尿道压均降低,且同期组相较于分期组Qmax更高,RU、IPSS评分、最大尿道闭合压、最大尿道压更低,差异有统计学意义(P<0.05);同期组膀胱癌复发率及前列腺窝种植转移率均低于分期组(P<0.05)。结论针对膀胱癌合并前列腺增生患者采取同期TURBT术与PKRP术同期治疗疗效较好,肿瘤复发及转移风险较低。

Searching for the Lost Ostium: A Morphometric Analysis of the Ureteral Ostia Distribution in Normal and Thickened Bladders and Its Applications in Endourology

Introduction: The ureteral ostia may not be easily identified in urological endoscopic procedures, leading to an incomplete diagnosis of urinary tract diseases or a predisposition to iatrogenic lesions. The purpose of our study is to evaluate the anatomical distribution of ureteralostia in normal bladders and those with thickened walls. Materials and Methods: We dissected 30 vesical-prostate blocks from human cadavers and identified the ostia of the bladder trigone. A computerized morphometric analysis was performed to measure the thickness of the detrusor muscle, the distances between the ureteral ostia themselves and the distances between each ureteral ostium (left—LUO and right—RUO) and the internal urethral ostium (IUO). The angle formed between the IUO and LUO/RUO was also recorded as well as the volume of the prostates. Results: Fifteen bladders with a non-thickened detrusor (6 mm) were identified. The average prostatic volume of the dissected blocks was 23.7 cm3. The distance between ureteral ostia, the distance from IUO to LUO, the distance from IUO to RUO and the angle formed between IUO and LUO/RUO in normal and thickened bladder were, respectively, 1.9 cm/2.2 cm (p = 0.09), 1.6 cm/1.6 cm (p = 0.82), 1.6 cm/1.7 cm (p = 0.79) and 77/91 (p = 0.17). Conclusions: Our study shows that there is no significant difference in the position of bladder ostia in healthy and thickened bladders. We believe that our findings may facilitate locating the ureteral orifices in situations where endoscopic identification is difficult.

miR-154、miR-22与膀胱癌患者病理特征关系及预测TURBT后复发价值

目的探讨微小RNA-154(miR-154)、微小RNA-22(miR-22)与膀胱癌患者病理特征关系及预测经尿道膀胱肿瘤电切术(TURBT)后复发价值。方法选取2019年1月至2022年12月华北理工大学附属医院收治的150例膀胱癌患者作为研究对象,统计癌组织和癌旁组织、不同病理特征患者miR-154、miR-22表达水平,采用Spearman相关分析不同病理特征与miR-154、miR-22表达水平的相关性。根据患者TURBT后复发情况将其分为复发组和未复发组,比较两组miR-154、miR-22表达水平。绘制受试者工作特征(ROC)曲线分析miR-154、miR-22预测TURBT后复发的效能。采用卡普兰-迈耶生存曲线(K-M)进行不同miR-154、miR-22表达水平患者生存状况分析。结果膀胱癌患者癌组织miR-154、miR-22表达水平均低于癌旁组织,差异均有统计学意义(P<0.05)。不同临床分期、分化程度、淋巴结转移膀胱癌患者miR-154、miR-22表达水平比较,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,临床分期、淋巴结转移与miR-154、miR-22均呈负相关(P<0.05),分化程度与miR-154、miR-22呈正相关(P<0.05)。150例膀胱癌患者TURBT后共有15例失访,32例复发,103例未复发,分别纳入复发组和未复发组。复发组miR-154、miR-22表达水平均低于未复发组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,miR-154、miR-22预测TURBT后复发的曲线下面积(AUC)分别为0.823、0.817,当最佳截断值为0.44、0.71时,灵敏度为78.12%、87.50%,特异度为75.73%、63.11%。miR-154、miR-22联合预测TURBT后复发的AUC为0.854,灵敏度及特异度分别为90.62%、92.23%。150例膀胱癌患者TURBT后共有15例失访,124例生存,11例死亡。根据ROC曲线中miR-154、miR-22最佳截断值为界限,≤最佳截断值为低表达,>最佳截断值为高表达。K-M曲线分析结果显示,miR-154、miR-22低表达患者生存率分别为88.16%(67/76)、88.00%(66/75),低于miR-154、miR-22高表达患者的98.31%(58/59)、98.33%(59/60),差异均有统计学意义(χ^(2)=55.821、55.960,P<0.001)。结论膀胱癌患者癌组织miR-154、miR-22水平与淋巴结转移、临床分期、分化程度密切相关,二者联合检测有助于提高TURBT后复发预测效能,指导临床诊治,改善预后。

Photodynamic Therapy Combined with Electrosurgical Resection for Recurrent Bladder Cancer

Bladder tumor is characterized by recurrent recurrence and distant metastasis,which determines the difficulty of completely curing bladder tumor.In recent years,the number of patients with bladder cancer is increasing,and the treatment of bladder cancer has become an important direction of clinical research.It is difficult to control bladder tumor by traditional therapy.Photodynamic therapy(PDT),as a new optical therapy,has gradually become the main method in clinical treatment of bladder tumor combined with transurethral resection of bladder tumor.In this paper,a patient with superficial recurrent bladder tumor was treated by photodynamic therapy combined with transurethral resection of bladder tumor.The advantages of photodynamic therapy in the treatment of bladder tumor and the selection of photosensitizer in the process of photodynamic therapy were discussed.After two recurrences,the patients chose photodynamic therapy.The tumors were resected one by one,and the wound was coagulated by roller electrode.After the drug was retained for 20 minutes,the bladder was empty.The spherical optical fiber was implanted into the bladder.The photodynamic energy was adjusted(light power 1.8 W,light time 1302 s).There was no recurrence after operation.Most bladder tumors are superficial tumors,and bladder is a cavity organ,which determines that bladder is an ideal organ for photodynamic therapy.As a targeted drug,photosensitizer is only absorbed by bladder tumor after being perfused into bladder.The photosensitizer forms reactive oxygen species through oxygen and kills tumor cells.Clinical practice has proved that PDT has its unique advantages for superficial and recurrent bladder tumors.As the first generation photosensitizer,xipofen also has selectivity in the treatment of bladder cancer.

Mechanism research of pirarubicin postoperative immediately bladder irrigation combined compound matrine injection on treating superficial bladder cancer

Objective:Investigate the mechanism of Pirarubicin postoperative immediately bladder irrigation combined compound matrine injection on treating superficial bladder cancer, thus to provide assistance for clinical therapy of superficial bladder cancer.Methods:A total of 90 cases of patients with superficial bladder cancer treated in our hospital were selected, and randomly divided to be control group and combination group, 45 cases for each. For patients in control group, treatment of Pirarubicin postoperative immediately bladder irrigation was provided after transurethral resection of bladder tumors. For patients in combination group, combined treatment of Pirarubicin postoperative immediately bladder irrigation and compound matrine injection were provided after transurethral resection of bladder tumors. T lymphocyte subsets, cytokines, liver and renal functions of patients in each group were detected before and after treatment.Results: No statistical difference showed on T lymphocyte subsets, cytokines, liver and renal functions between two groups of patients with superficial bladder cancer before and after treatment. Compared with prior treatment, CD8+, cytokines (IFN-γ and IL-2), liver function indexes (AST and ALT) and renal function indexes (BUN and Cre) were significantly increased in two groups of patients after treatment, while T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) and cytokines (TNF-α, IL-6 and CRP) were significantly decreased. Differences showed statistical significance. After combined treatment given, T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) and cytokines (IFN-γ and IL-2) in combination group were significantly higher than in control group after treatment, cytokines (TNF-α, IL-6 and CRP), CD8+, liver function indexes (AST and ALT) and renal function indexes (BUN and Cre) were significantly lower than in control group after treatment. Differences between the two groups showed statistical significance.Conclusion:Combination of Pirarubicin postoperative immediately bladder irrigation and compound matrine injection could enhance immune functions, improve inflammatory reactions and decrease chemotherapeutics toxicities for patients with superficial bladder cancer. It is of great significance on clinical therapy for those patients.

Cryoablation techniques in bladder cancer: A review

Bladder cancer(BC)ranks as the tenth most common cancer globally.Histopathologically,BC is broadly categorized into urothelial and non-urothelial BC.Urothelial carcinoma represents over 90%of BC in most regions worldwide.The standard treatment procedure for diagnosing and treating non-muscle-invasive bladder cancer(NMIBC)is transurethral resection of bladder tumors(TURBT).Currently,the standard of care for muscle-invasive bladder cancer(MIBC)is neoadjuvant chemotherapy followed by radical cystectomy.Cryoablation therapy is a medical technique that uses extremely low temperatures to destroy diseased tissue.This treatment serves as a therapeutic tool for both benign and malignant diseases in organs such as the kidney,prostate gland,lung,liver,and breast,and is particularly effective for unresectable tumors,offering less trauma,quick recovery,good tolerability,and symptom control.However,cryoablation has its limitations.Over the past few years,cryoablation therapy has emerged as a new method for treating early BC.This treatment is minimally invasive,precise,and offers quick recovery,providing patients with a new treatment option.Although randomized studies are still limited,increasing evidence suggests its potential application in bladder cancer combined with transurethral resection(TURBT)or medication.Cryoablation is not standard therapy for bladder cancer.Treatment decisions should be discussed by a multidisciplinary team of urologists,oncologists,and interventional physicians and require more randomized controlled trials to define patient selection criteria and treatment approaches.

腰-硬联合麻醉复合超声引导下闭孔神经阻滞在TURBT术中的应用

目的探讨腰-硬联合麻醉复合超声引导下闭孔神经阻滞在经尿道膀胱肿瘤电切术(TURBT)中的应用效果。方法前瞻性选取2020年1月至2023年1月于郑州人民医院行TURBT术的86例膀胱肿瘤患者作为研究对象,根据随机数表法将患者分为观察组(腰-硬联合麻醉复合超声引导下闭孔神经阻滞)和对照组(腰-硬联合麻醉)各43例。比较两组患者的手术一般情况(麻醉时间、手术时间、术中出血量、术后住院时间、导管留置时间)、麻醉满意度和麻醉方式满意度、各时间点(麻醉前、麻醉后5 min、麻醉后30 min及手术结束时)平均动脉压(MAP)和心率(HR)、手术前后血气分析指标[动脉血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))]和疼痛程度[视觉模拟量表(VAS)]及术后不良反应发生情况。结果观察组患者术后麻醉时间、手术时间、术中出血量、术后住院时间和尿管留置时间明显短(少)于对照组,差异均有统计学意义(P<0.05);观察组患者麻醉满意度及麻醉方式满意度评分明显高于对照组,差异均有统计学意义(P<0.05);麻醉前两组患者的MAP及HR水平比较差异均无统计学意义(P>0.05);观察组患者麻醉后各时间点的MAP及HR与其麻醉前比较差异均无统计学意义(P>0.05),而对照组患者麻醉后各时间点的MAP及HR与其麻醉前比较差异均有统计学意义(P<0.05),且麻醉后各时间点,观察组患者的HR明显低于对照组,而MAP明显高于对照组,差异均有统计学意义(P<0.05);术前及术后,两组患者的SaO_(2)、PaO_(2)、PaCO_(2)水平比较差异均无统计学意义(P>0.05),但术后24 h,观察组患者的VAS评分为(2.09±0.88)分,明显低于对照组的(4.51±1.27)分,差异有统计学意义(P<0.05);观察组患者的总不良反应率为6.98%,明显低于对照组的37.21%,差异有统计学意义(P<0.05)。结论腰-硬联合麻醉复合超声引导下闭孔神经阻滞在TURBT术中应用具有较好的临床表现,且安全性更高。

膀胱肿瘤病人TURBT术后认知情绪现状及其影响因素分析

目的:了解膀胱肿瘤病人经尿道膀胱肿瘤电切术(TURBT)后认知情绪现状,并分析其影响因素。方法:选取2020年6月—2023年5月医院收治的89例膀胱肿瘤病人为研究对象,采用一般资料调查表、认知情绪调节量表(CERQ)评估病人TURBT术后认知情绪现状,经Logistic回归分析其影响因素。结果:89例膀胱肿瘤病人中有40例病人倾向消极认知情绪调节策略,占44.94%。Logistic回归分析显示,学历为初中及以下、家庭月均收入≤5000元、社会支持低水平、自我效能低水平均为膀胱肿瘤病人TURBT术后消极认知情绪的影响因素(P<0.05)。结论:膀胱肿瘤病人TURBT术后认知情绪可能受学历、家庭经济、社会支持、自我效能因素影响,临床应重点关注,实施针对护理措施以改善病人认知情绪。

矛头蝮蛇血凝酶对膀胱癌TURBT术后止血的应用价值

目的观察矛头蝮蛇血凝酶对经尿道膀胱肿瘤电切术(TURBT)术后止血的应用效果。方法选取98例行TURP手术治疗的膀胱癌患者,按照随机数字表法分为两组。常规组49例,术后予以常规电凝止血,试验组49例,术后经局部加用矛头蝮蛇血凝酶止血,比较两组的止血效果、凝血功能及预后情况。结果治疗后,试验组的术后出血量、膀胱冲洗时间、尿液转清时间及导尿管留置时间均低于常规组,差异有统计学意义(P<0.05)。试验组的APTT、PT、TT以及PAI-1、t-PA略高于常规组,但差异无统计学意义(P>0.05)。术后,试验组BC、Qmax均高于常规组,BSSS评分、术后并发症发生率低于常规组(P<0.05)。结论TURBT术后局部加用矛头蝮蛇血凝酶可在不影响患者凝血功能及纤溶系统功能的情况下,产生显著止血效果,对促进患者术后膀胱功能恢复并降低并发症发生风险均有积极意义。

TURBT对非肌层浸润性膀胱癌复发的影响

目的探讨经尿道膀胱肿瘤切除术治疗非肌层浸润性膀胱癌的临床疗效。方法选择非肌层浸润性膀胱癌患者128例,采用经尿道膀胱肿瘤切除术治疗,术后辅以膀胱灌注,定期进行复查,跟踪随访肿瘤的复发情况。结果128例患者均手术顺利,膀胱肿瘤切除率100%。平均手术时间为28.63 min;术中12例发生闭孔神经反射,3例膀胱穿孔。术后无1例出现大出血及电切综合征等并发症;术后有9例患者需膀胱连续冲洗,术后尿管保留时间为3.87天。所有患者术后随访3~60个月,其中8例患者为术后3个月内复发,5例患者为术后6个月内复发,7例患者为术后12个月内复发,3例患者为18个月内复发,2例患者为2年后复发,1例患者为3年后复发,复发率为20.31%。26例复发患者中,15例患者为原位复发,11例患者为异位复发。结论经尿道膀胱肿瘤切除术治疗非肌层浸润性膀胱癌,不仅保留了膀胱,而且操作简单、创伤小、并发症少、恢复快,已成为临床首选方法。

PK-TURBT联合羟喜树碱治疗非肌层浸润性膀胱癌

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。

HOLRBT与TURBT对表浅性膀胱癌的临床疗效分析比较

目的探讨经尿道钬激光膀胱肿瘤切除术（HOLRBT）与经尿道膀胱肿瘤电切术（TURBT）对表浅性膀胱癌的临床疗效及尿管留置时间的差别。方法回顾性分析120例膀胱癌患者的临床资料,根据其手术方式分为HOLRBT组和TURBT组。观察两组患者手术一般情况,比较两组患者手术前后排尿功能、生活质量和并发症发生情况的差别。结果 HOLRBT组患者术中出血量较TURBT组少,术后留置尿管时间较TURBT组短（t=27.352、8.854,P﹤0.001）;两组患者术后1个月的排尿功能差异无统计学意义,术后6个月,HOLRBT组的IPSS得分低于TURBT组,Qmax得分高于TURBT组（t=43.619、-8.412,P﹤0.001）;两组膀胱穿孔、继发性出血和发热并发症发生情况差异无统计学意义（χ2=.163,P=0.281）,HOLRBT组复发情况明显低于TURBT组（χ2=.881,P=0.027）;两组患者手术前生活质量得分差异无统计学意义,术后1个月,HOLRBT组躯体功能、躯体角色和总体健康等维度得分高于TURBT组。结论经尿道钬激光膀胱肿瘤切除术对膀胱癌有较好的治疗效果,安全性高,可减少复发,具有临床推广应用的价值。

TURBt联合髂内动脉灌注化疗治疗浸润性膀胱癌

目的 :寻求浸润性膀胱癌的有效治疗方法。方法 :对经尿道膀胱肿瘤切除术 (TURBt)联合髂内动脉化疗的 12例浸润性膀胱癌患者临床资料进行回顾性分析。结果 :2年内死亡 3例 ,生存 2～ 4年 6例 ,生存 5年以上 3例 ,没有明显的并发症。结论 :TURBt联合髂内动脉化疗为晚期浸润性膀胱癌 。

非肌层浸润性膀胱癌TURBT术后吡柔比星与丝裂霉素灌注化疗临床效果比较

目的比较非肌层浸润性膀胱癌经尿道膀胱肿瘤切除术(transurethral resection of bladder tumor,TURBT)术后吡柔比星与丝裂霉素灌注化疗的临床效果。方法选取2013年1月至2016年1月本院收治的94例非肌层浸润性膀胱癌患者为研究对象。按照随机数表法将其分为观察组和对照组,每组各47例。两组患者均接受TURBT治疗,术后对照组患者采用丝裂霉素灌注化疗,观察组患者采用吡柔比星灌注化疗,疗程均为12个月。比较两组患者不良反应发生率、生活质量各领域评分及随访24个月复发率。结果观察组患者不良反应发生率显著低于对照组(P <0.05)。治疗后两组患者社会、认知、日常生活、情感及生理评分均显著高于本组治疗前(P_均<0.05);治疗后观察组患者社会、认知、日常生活、情感及生理评分均显著高于同期对照组(P_均<0.05)。随访24个月,观察组患者复发率显著低于对照组(χ2=4.209,P <0.05)。结论非肌层浸润性膀胱癌患者TURBT术后采用吡柔比星灌注化疗,临床效果明显,不良反应少,复发率低,且可明显改善患者生活质量。

TURBT联合膀胱内BCG灌注治疗肌层浸润性膀胱癌疗效分析

目的探讨选择性经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)治疗经选择的肌层浸润性膀胱尿路上皮癌患者保留有功能性膀胱的可行性。方法回顾性分析大连医科大学附属第二医院2006年至2011年间323例行TURBT治疗的膀胱尿路上皮癌患者的临床资料,选择术前影像学检查无明显膀胱外浸润,肿瘤单发,直径5cm以下,局限于膀胱顶壁、底壁及侧壁,距输尿管口1cm以上,不伴有原位癌,肿瘤创缘及基底部活检为阴性的T2期患者为研究对象,接受选择性TURBT伴膀胱内灌注BCG的保膀胱治疗。术后膀胱镜密切随访5~10年,运用统计学分析生存率、疾病特异生存率和无复发生存率评价疗效。结果入组31例患者,5年总体生存率、疾病特异生存率和无复发生存率分别为87%、93%和58%。复发15例,浅表性复发6例,8例接受延迟膀胱癌根治术。23例保留有功能性膀胱,死亡6例。结论选择性TURBT治疗肌层浸润性膀胱癌在少部分经严格选择的患者中是合理可行的,术后患者应终生接受膀胱镜严密随访。

髂内动脉栓塞化疗联合TURBT治疗膀胱癌疗效观察

应用髂内动脉栓塞化疗术联合经尿道膀胱肿瘤切除术（TURBT）治疗膀胱肿瘤9例。结果3年复发率为22．2％，与同期膀胱部分切除术（20％）相同，明显低于单纯膀胱肿瘤电切术（3．5％）。显示动脉栓塞化疗可使肿瘤血管萎缩，瘤体明显缩小，控制严重血尿，减少术中出血，防止肿瘤细胞播散转移，促使粘膜原位癌消失，增加了肿瘤电切的切除率。认为这种联合治疗方法可以取代膀胱部分切除术，对减少膀胱部分切除的次数，保留膀胱及其生理功能有一定意义。