T2a期膀胱尿路上皮癌行二次电切的应用价值

中华腔镜泌尿外科杂志（电子版）2019年4月第13卷第2期Chin J Endourol（Eiectronic Edition）,April2019,VoL13,No.2•125-

•临床研究•T2a期膀胱尿路上皮癌行二次

电切的应用价值

周先明疏仁义郭荣利董平柯磊磊黄进夏伟

【摘要】目的探讨二次根治性电切术在T2a期膀胱尿路上皮癌上的应用价值，为临床应

用提供参考。方法冋顾性分析2011年3月至2017年2月首次入住我科拒绝行根治性膀胱切除术或

不能耐受根治手术的52例CT分期T2a膀胱尿路上皮癌患者（术后病理证实），其中22例行二次电切

的为A组，30例行一次电切的为B组。两组手术均由高年资主治以上医师操作完成，术后

行膀胱灌注化疗药物并长期随访结果A组：其中1例二次电切时发现膀胱内大量坏死组织.

电切困难，遂改为膀胱部分切除术，术后病理为低级別非浸润性膀胱癌，21例行二次根治性电切术，

随访1~67个月（平均43个月），复发5例，复发率22.7%，均保留膀胱B组：随访15-54个月（平ansoft

歌剧伤逝

均40个月）,22例复发，7例丢失膀胱.1例肿瘤肺转移死亡：结论二次膀胱电切术为T2a期膀胱

癌提供一种新的选择.冇助于保留膀胱功能，可能对临床有一定的意义。

【关键词】膀胱尿路上皮癌；膀胱肿物切除术；冋顾性分析

Application value of secondary electrotomy for stage T2a urothelial carcinoma of the bladder

Zhou Xi a t iming,Shu Renyi,Guo Rongli,Dong Ping,Ke L e ilei,Huang Jin,Xia Wei.Department of Urology,

the People's Hospital of C hizhou,Anhui247000,China唐纳德

Corresponding author:Shu Renyi,Email:892312905@qq

[Abstract]Objective To explore the application value of secondary radical electrotomy in the

treatment of stage T2a urothelial carcinoma of the bladder,to provide reference for clinicians.Methods

Clinical data of52patients who were diagnosed with stage T2a urothelial carcinoma of the bladder on

image（confirmed by postoperative pathology）,refused or could not tolerate radical cystectomy admitted

射频宽带放大器to our hospital for the first time from March,2011to February,2017were retrospectively analyzed.

Among them,22patients undergoing twice electrotomy were assigned in group A and30patients receiving

once electrotomy were allocated in group B.In both groups,electrotomy was performed by experienced

surgeons.Postoperative intravesical chemotherapy and long-term follow-up were con d ucted.Results

In group A,a large quantity of necrotic tissues was detected in the bladder of one patient during the

secondary electrotomy.Intraoperatively,it was difficult to perform electrotomy,which was switched to

partial cystectomy.Postoperatively,the patient was pathologically diagnosed with low-grade non-invasive

bladder cance匚Twenty-one patients underwent secondary radical electrotomy and were followed up for1-

67months,43months on average.Five cases recurred with a recurrence rate of22.7%.All patients

preserved the bladder.In group B,postoperative follow-up endured for15-54months（40months on

岭南空间average）.Twenty-two patients recurred,the bladder was resected in7cases and1patient died of lung矿产资源法实施细则

metastasis.Conclusion Secondary electrotomy provides a novel treatment option for T2a stage bladder

cancer,which can preserve the bladder function and may be of clinical significance.

[Key words]Urothelial carcinoma of the bladder;Resection of bladder tumor;Retrospective

analysis

DOI:10.3877/cma.j.issn.1674-3253.2019.02.013

作者单位：247000安徽，池州市人民医院泌尿外科

通信作者：疏仁义.Email：892312905@qq

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标签：膀胱治疗上皮尿路安徽电切术例行根治性

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