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1、高危非肌层浸润性膀胱癌二次经尿道电切治疗体会第32卷第1期2011年2月同济大学(医学版)JOURNALOFTONGBUNIVERSITY(MEDICALSCIENCE)V01.32No.1Feb..2011doi:10.3969/j.issnl008—0392.2011.01.089?临床研究?高危非肌层浸润性膀胱癌二次经尿道电切治疗体会陈兴屹,温机灵,陈卫华,温晓飞,杨波,王跃闽(同济大学附属东方医院泌尿外科,上海200120)【摘要】目的探讨二次经尿道电切(repeat~ansurethralresection,ReTUR)在高危非肌层侵润性膀胱癌治疗中的效果及
2、意义.方法我院自2005年5月_一20l0年5月期间治疗高危非肌层侵润性膀胱癌患者45例(男性24例,女性21例,年龄37～84岁,平均56.7岁),肿瘤直径0.3—4.0cm,数目1～6枚,术后常规吡柔比星膀胱灌注化疗.4周后入院行ReTUR.结果本组患者ReTUR术后病理显示35.69%(16/45)有肿瘤残留,其q-Ta期2例,1f1期12例,12期2例.4例(8.7%)患者在初次电切术时低估肿瘤分期,2例患者因此更改治疗方案.ReTuR术中膀胱穿孔1例,保守治疗自愈.结论高危膀胱肿瘤残留率高,应常规行ReTUR,能提高分期的准确性,优化治疗方案,改善患者预后.
3、【关键词】膀胱肿瘤;高危;TURBT;ReTUR【中图分类号】R699.5【文献标志码】A【文章编号】1008—0392(2011)0卜0089—03Effectofrepeattransurethralresectiononhighrisknon-muscleinvasivebladdercancerCHENXing—yi,WENJi-ling,CHENWei-hua,WENXiao-fei,YANGBo,WANGYue—min(Dept.ofUrinarySurgery,EastHospital,TongjiUniversity,Shanghai200120,Ch
4、ina)【Abstract】ObjectiveTostudytheeffectsandimplicationsofrepeattransurethralresection(ReTUR)onhigh—risknon—muscleinvasivebladdercancer.MethodsFromMay2005toMay2010,atotalof45caseswithhigh—risksuperficialbladdercancerwereenrolled.Therewere24malesand21femalesagingfrom37to84years(anaverageo
5、f56.7yearsold),whosetumorsizewasfrom0.3to4.0cmandthenumberoftumorfrom1to6.Pirarubicinwereadministeredtoallthepatients'bladderafterinitialresection.ReTURwasperformedafter4weeks.Results35.69%(16/45)hadresidualtumorincluding2ofTa,12ofT1and2ofT2.Fourcases(8.7%)wereunderstagedatinitialresect
6、ion;therefore,2patientschangedthetreatment.Onecasehadbladderperforationduringrepeattransurethi'alresection,whichwasspontaneouslycuredaftertheexpectanttreatment.ConclusionHigh-risknon—muscleinvasivebladdercancerhasahighrateofcancerresidualafterinitialresection.RoutineReTURishelpfultothep
7、recisepathologicalstagingofcancerandtheimprovementoftheprognosis.【Keywords】bladderneoplasms;high.risk;TURBT;ReTUR收稿日期:2010—07—20作者简介:陈兴屹(1973一),男,主治医师,学士.E—mail:chensacn@yahoo.corn.cn?89?同济大学(医学版)第32卷经尿道膀胱肿瘤电切术(transurethralresectionofbladdertumor.TURBT)是非肌层浸润性膀胱癌治疗的金标准.文献报道显示,
