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目的:总结应用2μm激光气化切除治疗表浅性膀胱肿瘤的临床特点。方法:采用RevoLix 2μm激光于骶管麻醉或表面麻醉下行经尿道气化切除72例表浅性膀胱肿瘤,男59例,女13例,年龄27～88岁,平均60.5岁。单发肿瘤60例,多发12例。肿瘤病理分级膀胱移行细胞癌G_1级21例,G_2级51例,肿瘤直径0.3～3.5cm。结果:所有患者均可耐受手术,手术平均时间10min,术中出血量少,无闭孔神经反射、继发出血。所有患者术后均不需膀胱冲洗,77.8%的患者术后接受了即刻膀胱灌注化疗,其他患者在5天之内开始膀胱灌注化疗,平均随访16.5个月(3～26个月),复发6例,肿瘤复发率为8.3%,无原位复发。结论:2μm激光气化切除术是治疗表浅性膀胱肿瘤高效、安全的方法,可灵活选择麻醉方式,并在减少膀胱穿孔及出血、减少术后冲洗、提高即刻灌注比例方面具有优势。
Objective: To summarize the clinical features of superficial bladder tumor treated with 2μm laser vaporization resection. METHODS: Seventy-two cases of superficial bladder tumors were resected with cautery or surface anesthesia via RevoLix 2μm laser. There were 59 males and 13 females, aged 27-88 years (average 60.5 years). Single tumor in 60 cases, multiple in 12 cases. Tumor pathological grading bladder transitional cell carcinoma G_1 grade 21 cases, G 2 grade 51 cases, tumor diameter 0.3 ~ 3.5cm. Results: All patients were able to tolerate surgery. The mean time of operation was 10 minutes. There was less intraoperative blood loss, no obturator nerve reflex and secondary hemorrhage. All patients underwent no bladder irrigation postoperatively, 77.8% received immediate intravesical instillation chemotherapy postoperatively, and other patients started intravesical chemotherapy within 5 days, with an average follow-up of 16.5 months (range 3 to 26 months) and relapse 6 For example, the tumor recurrence rate was 8.3%, with no recurrence in situ. Conclusions: 2μm laser vaporization resection is an effective and safe method for the treatment of superficial bladder tumors. It can flexibly select the anesthesia method and has advantages in reducing bladder perforation and bleeding, reducing postoperative irrigation, and improving immediate perfusion rate.