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目的:探讨钬激光治疗浅表性输尿管及膀胱肿瘤的手术方法及疗效。方法:2008年7月～2011年4月采用钬激光治疗浅表性输尿管肿瘤3例,治疗膀胱侧壁浅表性肿瘤42例。其中,输尿管肿瘤冠顶直径0.5～1.0 cm,带蒂,1例为孤立肾,1例对侧肾发育不良,1例年老体弱,合并房颤,均为单发。膀胱侧壁肿瘤冠顶直径0.5～6.0 cm,平均1.2 cm,肿瘤单发38例,多发4例。原发肿瘤37例,非原位复发肿瘤8例。术后随访3个月～3年。结果:45例手术几乎无出血,无输尿管及膀胱穿孔。术后随访至今,3例输尿管瘤均未复发,42例膀胱癌8例复发,无原位复发及远处转移。结论:钬激光治疗膀胱侧壁肿瘤无闭孔神经反射,可明显减少膀胱穿孔的发生率;治疗特殊病例的输尿管肿瘤具有创伤小、恢复快、术后并发症少等优点,同时明显降低术后发生肾功能不全的风险,提高生活质量。
Objective: To investigate the surgical method and curative effect of holmium laser in treatment of superficial ureter and bladder tumor. Methods: From July 2008 to April 2011, 3 cases of superficial ureteral tumors were treated with holmium laser and 42 cases of superficial tumors of the bladder were treated. Among them, the ureteral tumor crown diameter 0.5 ~ 1.0 cm, pedunculated, 1 case of isolated kidney, 1 case of contralateral renal dysplasia, 1 cases of frail, with atrial fibrillation, are single. Bladder wall tumor crown diameter of 0.5 ~ 6.0 cm, an average of 1.2 cm, 38 cases of single tumor, multiple in 4 cases. 37 cases of primary tumor, non-situ tumor recurrence in 8 cases. Follow-up 3 months to 3 years. Results: There were almost no bleeding and no ureter and bladder perforation in 45 cases. Up to now, none of the three ureteral tumors recurred, and eight of 42 cases of bladder cancer recurred, with no recurrence in situ and distant metastasis. Conclusion: Holmium laser treatment of bladder tumor without obturator nerve reflex, can significantly reduce the incidence of bladder perforation; the treatment of special cases of ureteral tumors with less trauma, rapid recovery, less postoperative complications, while significantly reducing the postoperative Risk of renal insufficiency, improve quality of life.