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目的:总结应用经尿道选择性绿激光汽化术治疗非肌层浸润性膀胱癌患者的疗效。方法:2004年-2008年,在骶管麻醉下利用经尿道选择性绿激光汽化术对56例非肌层浸润性膀胱癌患者进行肿瘤汽化术。应用80W绿激光,行经尿道膀胱肿瘤汽化术。治疗时间5-50min,平均20min,术后留置尿管1-7d,均无出血。术后结合立刻吡柔比星膀胱灌注化疗及长期规律吡柔比星膀胱灌注化疗,术后前2年中每3个月随访一次,第3年开始每6个月随访一次。结果:本组56例患者均直接汽化成功,无出血,肿瘤汽化至肌层。54例术后每3个月复查膀胱镜见肿瘤消失、膀胱黏膜修复完整,2例分别术后3月、19个月膀胱肿瘤复发,治疗效果满意。结论:经尿道选择性绿激光汽化术治疗非肌层浸润性膀胱癌,是一种操作简单、安全、疗效确切的腔道泌尿外科理想的手术方法。
Objective: To summarize the curative effect of transurethral selective green laser vaporization in patients with non-muscle invasive bladder cancer. Methods: From 2004 to 2008, 56 patients with non-muscle invasive bladder cancer were treated with transurethral selective green laser vaporization under caudal anesthesia. Application 80W green laser, transurethral bladder tumor vaporization. Treatment time 5-50min, an average of 20min, postoperative indwelling catheter 1-7d, no bleeding. Postoperative combined with immediate intravesical instillation of pirarubicin chemotherapy and long-term regular pirarubicin bladder chemotherapy, follow-up every 3 months in the first 2 years after surgery, the first 3 years follow-up every 6 months. Results: All the 56 patients in this group were successfully vaporized without hemorrhage. The tumor was vaporized to the muscular layer. Of the 54 patients who underwent cystoscopy every 3 months after operation, the tumor disappeared and the bladder mucosa was repaired completely. Two cases had recurrent bladder tumor at March and 19 months after operation, respectively. The treatment effect was satisfactory. Conclusion: Transurethral selective green laser vaporization for the treatment of non-muscle invasive bladder cancer is an ideal surgical method for the operation of simple and safe operation.