输尿管口旁浅表性膀胧肿瘤的微创治疗

发表时间：2014-07-07 浏览次数：803次

引用：

张振丰，刘晓强，蔡启亮等.输尿管口旁浅表性膀胧肿瘤的微创治疗[J].临床泌尿外科杂志.2013,28(4):258-262

关键词：

膀胱肿瘤；输尿管口旁浅表性膀胱肿瘤；微创治疗；

作者：

张振丰，刘晓强，蔡启亮，刘雨，郭战军，王一，梁博，孙光

作者单位：

天津医科大学附属第二医院泌尿外科,天津泌尿外科研究所；

出版年份：

2013

期刊页数：

258-262

收录者：

知网

摘要：

目的:总结输尿管口旁浅表性膀胱肿瘤微创治疗的临床经验。方法:在连续硬脊膜外麻醉+患侧闭孔神经阻滞麻醉下行内腔镜手术治疗输尿管口旁浅表性膀胱肿瘤患者25例,其中21例肿瘤位于输尿管口周围2.0cm以内,但未累及输尿管口;4例肿瘤基底位于输尿管口内。经尿道先置入70°膀胱镜了解肿瘤具体情况,然后更换电切镜,从基底部将肿瘤及包括输尿管口在内的周围2cm正常膀胱黏膜快速一并完整切除。结果:25例手术均顺利结束,无出血、穿孔等并发症。25例均获得随访,时间为12～24个月,无输尿管口狭窄、闭锁、严重的膀胱-输尿管反流、肾功能受损等并发症发生。结论:经尿道微创手术治疗输尿管口旁浅表性膀胱肿瘤,操作简单,创伤小,可代替开放性手术。 Objective:To evaluate the minimally invasive treatment for superficial bladder cancer near ureteral orifice.Metbod;Lnrler continuous epidural anethesia adding affected side obturator nerve block, 25 patients with superfical bladder tumors next to the ureteral orifices were treated by endoscopic surgery. Among 21 cases.the tumors were located around the urethral orifices·within 2. 0 cm or Less.but not involving the ureteral orifices. For 4.the buses of tumors were in the orifices. Firstly, place 700 cystoscope by transurethral to watch the spe- cific situation。[tumors，and then replace the resectoscope. Lastly, resect the tumors together with the ureteral orifices，induding normal bladder mucosa around 2 cm of the orifices from the bases.quickly and completely. Re- suit:"hwcnty-five operations were performed smoothly, no bleeding, perforation and other complications. All the patients were followed up. The rime was between 12 months and 24 months. Vo stenosis and atresia of ureteral orifice.serious vesico ureteral reflux. or renal function damage happened. Conclusion: Minimally invasive manage- ment of superficial bladder tumor around ureteral orifice is better with technically easier, smaller trauma, more re- liable efficacy and can replace open surgery.

阅读全文