非肌肉浸润性膀胱肿瘤的腔内泌尿外科治疗

I. Vladanov
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摘要

背景:经尿道膀胱切除术是诊断、治疗和治疗非肌源性膀胱癌症的重要方法之一。该手术的目的是完全切除所有肉眼可见的肿瘤,随后建立非常精确的组织学诊断。本研究的目的是比较传统经尿道内窥镜治疗和使用不同类型能量源的整体切除法治疗膀胱肿瘤的结果。材料和方法:共有88名患者接受了泌尿系统内介入治疗。关于分布,23名患者接受了常规经尿道电切术、22-En组单极电切术,21-En组双极电切术和22-En组合Thu:YAG激光电切术。比较临床数据、术中和术后数据以及组织病理学检查结果。结果:比较组在年龄、性别、肿瘤特征(大小、数量、位置)方面存在异质性。比较研究组的术中和术后并发症,在手术过程中没有观察到显著差异。常规经尿道电切术后,74%的病例、91%的En组单极电切术、95%的En组合双极电切术和96%的En集团Thu:YAG激光电切术中检测到逼尿肌组织。结论:与传统的经尿道电切术相比,非肌肉性浸润性膀胱肿瘤整体切除术是一种安全有效的方法;它可以获得更有利的术后结果,并获得更好质量的肿瘤样本,从而能够建立对疾病的正确诊断。
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Endourological treatment of non-muscular-invasive bladder tumors
Background: Transurethral resection of the bladder is one of the essential methods in the diagnosis, treatment and management of non-muscularinvasive bladder cancer. The purpose of the procedure is to remove completely all visually detected tumors with a following establishment of a very precise histological diagnosis. The aim of the study is to compare the results of conventional transurethral endoscopic treatment and the En-bloc resection method using different types of energy sources in the treatment of bladder tumors. Material and methods: A total number of 88 patients underwent endourological interventions. Regarding the distribution, 23 patients had conventional transurethral resection, 22 – En-bloc monopolar resection, 21 – En-bloc bipolar resection and 22 – En-bloc with Thu:YAG laser. Clinical data, intraoperative and postoperative data and also the histopathological examination results were compared. Results: The compared groups were heterogeneous by age, sex, tumor characteristic (size, number, location). No significant differences were observed during the operations, comparing the intraoperative and postoperative complications of the studied groups. The detrusor musculature was detected in 74% of cases after conventional transurethral resection, in 91% of cases of En-bloc monopolar resection, in 95% of cases of En-bloc bipolar resection and in 96% of cases of En-bloc Thu:YAG laser. Conclusions: The En-bloc resection technique of non-muscular-invasive bladder tumors is a safe and effective method comparing with the conventional transurethral resection; it allows more favorable postoperative results and obtaining better quality tumor samples which allow establishing correct diagnosis of the disease.
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