摘要
目的 评估根治性经尿道膀胱肿瘤电汽化术 (根治性TUVBT)治疗膀胱肿瘤的中长期疗效。 方法 已侵犯肌层的膀胱肿瘤患者 39例。采用根治性TUVBT治疗 14例 ,获随访 12例 ,时间 34～ 6 6个月 ,平均 4 4 .6个月。参照根治性经尿道膀胱肿瘤电切术的手术原则 ,汽化切除肿瘤至膀胱壁外脂肪层。采用膀胱部分切除术治疗 2 5例 ,获随访 2 2例 ,时间 30～ 96个月 ,平均 5 0 .7个月。两组术后常规 10 羟基喜树碱膀胱灌注化疗 2年。 结果 根治性TUVBT组术后肿瘤复发率 33.3% (4 / 12 ) ;膀胱部分切除术组复发率 31.8% (7/ 2 2 ) ,死亡率 4 .5 % (1/ 2 2 )。两组比较 ,差异无显著性意义 (P >0 .0 5 )。 结论 对已侵犯肌层的膀胱肿瘤 ,根治性TUVBT可作为外科治疗的一种选择 ,尤其适用于年老体弱或不愿意接受根治性膀胱全切术或开放手术者。
Objective To evaluate the intermediate and long-term efficacy of radical transurethral electrovaporization for bladder tumor (radical TUVBT). Methods Thirty-nine patients with muscle-invasive bladder cancer were entered into the study.Of them 14 patients underwent radical TUVBT.The procedure was based upon the principle of radical transurethral resection for bladder tumor,with the muscle-invasive bladder cancers being electrovaporized to fatty layer outside the bladder wall,as full-thickness resection.12 cases were followed-up for 34 to 66 months with a mean period of 44.6 months.2 cases were lost of follow-up.The remaining 25 patients underwent partial cystectomy.22 cases were followed-up for 30 to 96 months with a mean period of 50.7 months.After operation bladder instillation with 10-hydroxyl camptothecine was given for two years in both groups. Results For radical TUVBT group the recurrence rate was 33.3% (4/12) and for partial cystectomy group the recurrence rate was 31.8% (7/22),with mortality rate being 4.5% (1/22).There was no significant difference between radical TUVBT group and partial cystectomy group ( P >0.05). Conclusions Radical TUVBT can be selected as surgical treatment for muscle-invasive bladder cancer cases,especially for those who are older and weak,and not medically fit for radical cystectomy or those who refuse the open surgery.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2003年第9期614-616,共3页
Chinese Journal of Urology
