经尿道海博刀黏膜下剥离整块切除非肌层浸润性膀胱癌的初步研究

李亚伟; 黄后宝; 卓栋; 程庆水; 徐玉节; 李生辉; 程浪

doi:10.13201/j.issn.1001-1420.2018.11.005

经尿道海博刀黏膜下剥离整块切除非肌层浸润性膀胱癌的初步研究

- 皖南医学院第一附属医院泌尿外科(安徽芜湖, 241001)
基金项目:
国家自然科学基金项目 (编号81802559)

安徽省教育厅重点项目 (编号KJ2018A0260)

皖南医学院第一附属医院引进人才基金 (编号KY21380345)

详细信息

通讯作者: 黄后宝,E-mail:drhuanghoubao@163.com

中图分类号: R737.14

收稿日期: 2018-10-08

Transurethral endoscopic submucosal en-bloc resection of non-muscle-invasive bladder cancer with Hybrid knife:initial experience

- Department of Urology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, 241001, China

More Information

Corresponding author: HUANG Houbao, E-mail: drhuanghoubao@163.com

Received Date: 08 October 2018

摘要

摘要: 目的:探讨应用海博刀黏膜下剥离整块切除非肌层浸润性膀胱癌(NMIBC)的有效性及安全性。方法:收集2015年3月~2018年8月我院明确诊断为NMIBC的患者,术中先于肿瘤基底黏膜注射亚甲蓝甘油果糖混合液,使肿瘤基底隆起,再用海博刀沿肿瘤边缘,将肿瘤于黏膜下完整剥除。结果:共40例患者入组,其中男32例,女8例;年龄41~89岁,平均(61±12)岁;肿瘤直径0.5~3.5cm,平均(2.0±0.8) cm。所有40例手术均顺利完成,手术时间30~90min,平均60min。术中无一例发生严重出血需要输血、无膀胱穿孔、闭孔神经反射及电切综合征。术后住院时间2~8d,平均(4.4±1.4) d。术后病理:1例为腺性膀胱炎;1例为轻度异型增生;38例为非肌层浸润性尿路上皮癌(Ta期14例,T1期24例),其中高级别6例,低级别32例。术后随访1~40个月,平均(17.5±11.7)个月,仅1例肿瘤复发。结论:膀胱肿瘤整块切除(ERBT)是NMIBC手术发展趋势,经尿道海博刀黏膜下剥离整块切除NMIBC安全、有效,具有临床应用价值。
- 膀胱肿瘤整块切除 /
- 海博刀 /
- 非肌层浸润性膀胱癌 /
- 黏膜下剥离
Abstract: Objective: To evaluate the safety and efficacy of transurethral endoscopic submucosal en-bloc resection of non-muscle-invasive bladder cancer by using Hybrid knife.Method: The information of non-muscle-invasive bladder cancer patients during 2015.3-2018.8 were collected.All tumors were treated with the procedure of submucosa dilation using the mixture of methylene blue and glycerol.Hybrid knife was used to cut the tumor integrally from the submucosa.Result: A total of 40 cases were enrolled including 32 males and 8 females.Their average age was (61±12) yrs, and the tumor size was 0.5-3.5 cm, averaging (2.0±0.8) cm.All operations were accomplished successfully, and the operation time was 30-90 min.No severe blood loss which needs blood transfusion, no obvious obturator nerve reflex or bladder perforation were found in all patients.The post-operation length of stay was from 2-8 days averaging (4.4±1.4) days.The pathology results:1 case was glandular cystitis, 1 case was mild epithelial dysplasia, the other 38 cases were non-muscle-invasive urothelium carcinoma (T_a14 cases, T₁24 cases) among which 6 cases high grade and 32 cases low grade cancer.One case of recurrence occurred during the mean follow-up period of (17.5±11.7) months.Conclusion: En-bloc resection of bladder tumor (ERBT) is the tendency of NMIBC operation.Transurethral submucosal dissection en-bloc resection of NMIBC by using Hybrid knife can be an effective, safe and excellent alternative procedure with few complications and a low recurrence rate.
- en-bloc resection of bladder tumor /
- Hybrid knife /
- non-muscle-invasive bladder cancer /
- endoscopic submucosal dissection

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