-
摘要: 膀胱软镜具有细小、柔软、弯曲的镜体和广角清晰的图像,在泌尿系疾病的治疗中具有很大的前景。通过对膀胱软镜的结构和功能的阐述,展现了膀胱软镜相比膀胱硬镜的优势,在泌尿系结石的治疗中体现了膀胱软镜能够辅助完成取石手术,并取得良好的清石率。在早期膀胱肿瘤的诊断与治疗中,结合窄带和荧光成像技术,提高了早期膀胱肿瘤的检出率和降低了术后的复发率。在男性尿道狭窄或断裂情况下,膀胱软镜的检查和治疗具有独特的优势,辅助腹膜外腹腔镜下肌层膀胱癌的部分切除具有重大的临床价值。阐述了膀胱软镜在临床上应用的优势,也提出了相关的不足,展望了膀胱软镜的相关日间手术模式会走向成熟的阶段。Abstract: The flexible cystoscopy has a small, soft, curved mirror and a wide-angle image, which has great prospects in the treatment of urinary diseases. Through the description of the structure and function of flexible cystoscopy, the advantages of the flexible cystoscopy compared to the cystoscope are demonstrated. In the treatment of urinary calculi, the flexible cystoscopy can assist the stone removal operation and achieve a good rate of stone clearance. In the diagnosis and treatment of early bladder tumors, combined with narrow-band and fluorescence imaging techniques, the detection rate of early bladder tumors is improved and the postoperative recurrence rate is reduced. In the case of male urethral stricture or fracture, the examination and treatment of flexible cystoscopy has unique advantages. Partial resection of assisted extraperitoneal laparoscopic myometrial bladder cancer has significant clinical value. The advantages of flexible cystoscopy in clinical application are expounded, and related deficiencies are also proposed. It is expected that the related day surgery mode of flexible cystoscopy will reach maturity.
-
Key words:
- flexible cystoscopy /
- urinary calculi /
- bladder tumor /
- minimally invasive treatment
-
-
[1] Schubert T,Rausch S,Fahmy O,et al.Optical improvements in the diagnosis of bladder cancer:implications for clinical practice[J].Ther Adv Urol,2017,9(11):251-260.
[2] Tully K,Palisaar RJ,Brock M,et al.Transurethral resection of bladder tumours:established and new methods of tumour visualisation[J].Transl Androl Urol,2019,8(1):25-33.
[3] 高峥岩,徐畅,刘同族,等.标准经皮肾镜联合膀胱软镜治疗复杂性肾结石的临床观察[J].现代泌尿外科杂志,2015,20(2):109-112.
[4] 李海元,花晨朝,周逢海.新型内镜成像技术在膀胱癌诊断中的应用进展[J].肿瘤防治研究,2016,43(5):418-421.
[5] Safiullah S,Lama DJ,Patel R,et al.Procedural Module:Flexible Cystoscopy[J].J Endourol,2018,32(S1):S2-S6.
[6] Kim JY,Kang SH,Cheon J,et al.The usefulness of flexible cystoscopy for preventing double-J stent malposition after laparoscopic ureterolithotomy[J].BMC Urol,2017,17(1):44.
[7] Dagnaes-Hansen J,Mahmood O,Bube S,et al.Direct Observation vs.Video-Based Assessment in Flexible Cystoscopy[J].J Surg Educ,2018,75(3):671-677.
[8] 黄向江,方烈奎,张轶庠,等.膀胱软镜联合钬激光门诊手术治疗下尿路结石[J].中华腔镜泌尿外科杂志(电子版),2016,10(4):243-246.
[9] Kim SB,Yoon SG,Tae J,et al.Detection and recurrence rate of transurethral resection of bladder tumors by narrow-band imaging:Prospective,randomized comparison with white light cystoscopy[J].Investig Clin Urol,2018,59(2):98-105.
[10] 熊波波,张劲松,王海峰,等.硕通镜联合钬激光治疗肾盂结石的临床疗效[J].昆明医科大学学报,2019,40(4):66-70.
[11] 刘迎,张轶庠,杨江根,等.经皮肾镜联合不同软镜治疗鹿角形肾结石的研究[J].临床泌尿外科杂志,2011,26(4):278-279,282.
[12] 陈海燕,李小鑫,李建明,等.经皮肾镜术中联合输尿管软镜治疗复杂性肾结石的疗效观察[J].微创泌尿外科杂志,2015,4(2):119-120.
[13] 陈利刚,易发现,陈利军,等.微创经皮肾镜联合膀胱软镜治疗复杂性肾结石的效果及其对患者生活质量的影响[J].中国医药导报,2018,15(33):51-55.
[14] 孙峰,翟玉章,陈保春,等.标准经皮肾镜联合膀胱软镜铥激光治疗复杂肾结石疗效分析[J].中国激光医学杂志,2017,26(4):181-184.
[15] 赵阳,张楠,马耀辉.微创经皮肾镜联合膀胱软镜治疗复杂性肾结石效果及预后分析[J].实用中西医结合临床,2017,17(3):29-30.
[16] 李应龙,丁国富,王勤章,等.微创经皮肾镜联合膀胱软镜治疗复杂性肾结石的疗效观察[J].中华腔镜泌尿外科杂志(电子版),2015,9(1):30-33.
[17] 杨昆霖,李学松,周利群.IUPU经腹腹腔镜联合膀胱软镜肾盂取石及肾盂成型术[J].泌尿外科杂志(电子版),2015,7(3):4-6.
[18] 李强,王勤章,丁国富,等.后腹腔镜肾盂切开联合膀胱软镜碎石取石术8例报告[J].现代泌尿外科杂志,2014,19(11):716-718.
[19] 肖亚,付卫华,张艮甫,等.后腹腔镜肾盂切开取石联合膀胱软镜钬激光碎石取石术治疗复杂性肾结石[J].局解手术学杂志,2014,23(5):474-476.
[20] 陈晓阳,丁献凡,马亮,等.应用膀胱软镜处理腹腔镜输尿管切开取石时移位至肾的结石[J].健康研究,2014,34(3):299-300.
[21] Su J,Zhu Q,Yuan L,et al.Combined laparoendoscopic single-site ureterolithotomy and flexible cystoscopy in the treatment of concurrent large upper ureteral and renal stones[J].Scand J Urol,2017,51(4):314-318.
[22] Sahin S,Resorlu B,Atar FA,et al.Laparoscopic Ureterolithotomy with Concomitant Pyelolithotomy Using Flexible Cystoscope[J].Urol J,2016,13(5):2833-2836.
[23] 马洪升.日间手术:一种富有挑战性的手术管理模式[J].华西医学,2019,34(2):113-115.
[24] 夏宝山,任维果,章建胜.膀胱硬软镜结合微创治疗尿道骑跨伤12例分析[J].南通大学学报(医学版),2014,34(6):578-579.
[25] Zare R,Grabe M,Hermann GG,et al.Can routine outpatient follow-up of patients with bladder cancer be improved?A multicenter prospective observational assessment of blue light flexible cystoscopy and fulguration[J].Res Rep Urol,2018,10:151-157.
[26] Kang W,Cui Z,Chen Q,et al.Narrow band imaging-assisted transurethral resection reduces the recurrence risk of non-muscle invasive bladder cancer:A systematic review and meta-analysis[J].Oncotarget,2017,8(14):23880-23890.
[27] Daneshmand S,Patel S,Lotan Y,et al.Efficacy and Safety of Blue Light Flexible Cystoscopy with Hexaminolevulinate in the Surveillance of Bladder Cancer:A Phase Ⅲ,Comparative,Multicenter Study[J].J Urol,2018,199(5):1158-1165.
[28] 刘利峰,田龙江,陈保春,等.局麻下经尿道膀胱软镜联合2μm激光治疗非肌层浸润性膀胱癌的临床观察[J].现代泌尿外科杂志,2017,22(7):504-506,512.
[29] 袁谦,张凌,汪青蓉,等.窄带光谱成像膀胱软镜与白光膀胱硬镜在非肌层浸润性膀胱癌术后随访中的应用比较[J].微创泌尿外科杂志,2018,7(3):188-191.
[30] 朱智能,袁敬东,章传华.窄带成像电子膀胱软镜在复发性膀胱癌精准活检的应用价值[J].临床泌尿外科杂志,2019,34(7):562-564,567.
[31] 刘强照,蔡忠林,庞捷,等.窄带成像辅助内镜与白光成像辅助内镜治疗非浸润性膀胱癌疗效的荟萃分析[J].中华泌尿外科杂志,2017,38(2):131-135.
[32] Ma T,Wang W,Jiang Z,et al.Narrow band imaging-assisted holmium laser resection reduced the recurrence rate of non-muscle invasive bladder cancer:a prospective,randomized controlled study[J].Zhonghua Yi Xue Za Zhi,2015,95(37):3032-3035.
[33] Dansk V,Malmström PU,Bläckberg M,et al.Hexaminolevulinate hydrochloride blue-light flexible cystoscopy in the detection and follow-up of nonmuscle-invasive bladder cancer:cost consequences during outpatient surveillance in Sweden[J].Future Oncol,2016,12(8):1025-1038.
[34] Smith AB,Daneshmand S,Patel S,et al.Patient-reported outcomes of blue-light flexible cystoscopy with hexaminolevulinate in the surveillance of bladder cancer:results from a prospective multicentre study[J].BJU Int,2019,123(1):35-41.
[35] Lotan Y,Bivalacqua TJ,Downs T,et al.Blue light flexible cystoscopy with hexaminolevulinate in non-muscle-invasive bladder cancer:review of the clinical evidence and consensus statement on optimal use in the USA-update 2018[J].Nat Rev Urol,2019,16(6):377-386.
[36] Clinton TN,Lotan Y.The use of blue light flexible cystoscopy with hexaminolevulinate & the diagnosis of bladder cancer[J].Future Oncol,2018,14(27):2805-2810.
[37] 金重睿,撒应龙,张炯,等.膀胱软镜在骨盆骨折后尿道狭窄患者中的应用及疼痛耐受性研究[J].中国内镜杂志,2017,23(1):15-19.
[38] Shaw G,Ioannou I,Gelister J,et al.Management of vesico-urethral anastomosis disruption after radical prostatectomy[J].Urol Int,2010,84(4):436-439.
[39] 袁道彰,徐晓龙,王丽艳,等.膀胱软镜联合腹腔镜膀胱部分切除术治疗肌层浸润性膀胱癌11例[J].中国微创外科杂志,2017,17(8):754-756.
[40] Nourparvar P,Leung A,Shrewsberry AB,et al.Safety and Efficacy of Ureteral Stent Placement at the Bedside Using Local Anesthesia[J].J Urol,2016,195(6):1886-1890.
[41] 张振声,潘安印,曹智,等.新型膀胱软镜鞘改善血尿状态下膀胱软镜视野效果的体外评价[J].第二军医大学学报,2013,34(2):205-208.
-
计量
- 文章访问数: 942
- PDF下载数: 362
- 施引文献: 0