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目的:探讨经尿道超脉冲等离子电切加气化相结合二步法切除侧壁浅表性膀胱肿瘤的安全性和有效性。方法:采用英国Gyrus公司第三代超脉冲等离子电切气化系统行经尿道超脉冲等离子电切加气化相结合二步法切除侧壁浅表性膀胱肿瘤(PKRVBt)78例。男51例,女27例.平均年龄55.7(34～72)岁。膀胱肿瘤单发42例,多发36例,膀胱肿瘤侧壁有分布者78例。术前均予膀胱镜检查活检病理证实为移行细胞癌,G_1期17例.G_2期61例,CT检查均为浅表性膀胱肿瘤。结果:经尿道超脉冲等离子电切加汽化相结合切除侧壁浅表性膀胱肿瘤(PKRVBt)手术时间16～65 min,平均(36±14)min,术中术后无明显出血。78例侧壁膀胱肿瘤切除时.早期2例发生闭孔神经反射后伴腹膜外型的膀胱壁穿孔,无电切综合症.无严重出血发生。随访12个月,9例复发并再行PKRVBt。结论:经尿道超脉冲等离子电切加气化相结合二步法切除侧壁浅表性膀胱肿瘤的方法,可有效避免闭孔神经反射、膀胱穿孔、严重出血等并发症的发生.是一种安全、有效的手术方式。
Objective: To investigate the safety and efficacy of transurethral ultrapulse plasma shunt and gasification combined with two-step excision of superficial bladder tumors in the lateral wall. Methods: A total of 78 cases of side wall superficial bladder tumor (PKRVBt) were excised by ultrathin plasma electrosurgical excision combined with two-step transurethral ultrathin plasma electrovaporization (GTP) system by Gyrus Company in the United Kingdom. 51 males and 27 females.The average age was 55.7 (34 ~ 72) years old. Bladder tumor 42 cases were single, multiple in 36 cases, there are 78 cases of bladder tumor sidewall distribution. Preoperative cystoscopy biopsy pathology confirmed as transitional cell carcinoma, G_1 17 cases.G_2 of 61 cases, CT examination were superficial bladder tumor. Results: Transurethral ultrapulse plasma electrovaporization combined with vaporization combined with excision of side wall superficial bladder tumor (PKRVBt) was performed in 16-65 minutes (36 ± 14) min with no significant postoperative bleeding. 78 cases of resection of the side wall of the bladder tumor in the early two cases of obturator nerve reflex with peritoneal bladder wall perforation, no cut-off syndrome. No severe bleeding. After 12 months of follow-up, 9 patients relapsed and re-performed PKRVBt. Conclusion: Transurethral ultra-pulse plasma tangential gasotomy combined with two-step excision of superficial bladder tumor can effectively prevent the occurrence of complications such as obturator reflex, bladder perforation and severe hemorrhage Safe and effective way of operation.