经尿道膀胱肿瘤电切术治疗肌层浸润性膀胱癌110例的疗效观察
发布时间：2019-05-11 03:11
【摘要】：目的:通过分析膀胱癌患者在行经尿道膀胱肿瘤电切术后,经过病理诊断为肌层浸润性膀胱癌且拒绝行根治性膀胱全切术的治疗效果及预后,为肌层浸润性膀胱癌患者的诊疗方案提供新的思路。方法:通过回顾性分析2011年1月至2015年12月于我院行经尿道膀胱肿瘤电切术(TURBT)治疗后,其病理诊断为肌层浸润性膀胱癌,并且拒绝行根治性膀胱全切术的患者110例,其中包括男性79例,女性31例。年龄38-89岁,平均年龄67.3岁,手术时完整切除肿瘤,深度达膀胱壁外脂肪层,范围至膀胱肿瘤周围0.5-1.0cm正常粘膜。术后105例患者进行膀胱灌注治疗,其中10例同时进行GC方案4周期的全身辅助化疗,5例行髂内动脉栓塞化疗术,另有5例术后失访。结果:在本组110例患者行膀胱肿瘤电切术,手术顺利,手术平均时间43min;术中出血量平均15ml,所有手术均未出现严重并发症;患者术后住院时间平均7.7天。术后成功随访患者105例,均进行了膀胱灌注治疗,其中10例进行GC方案4周期的全身化疗,5例行髂内动脉栓塞化疗术。术后复发28例,复发率26.7%,复发时间1-62个月,平均复发时间20.6个月。复发后行经尿道膀胱肿瘤电切术治疗18例,行膀胱部分切除术+GC方案+盆腔局部放疗1例,行膀胱全切术7例,保守治疗2例。随访时间不少于2年的患者有78例,复发21例,复发率26.9%,平均复发时间25.0月。至末次随访时间,共生存102例,3例患者死亡,其中1例因膀胱癌复发转移去世,1例因胃癌晚期转移死亡;1例患者于术后12个月死亡,原因不详。结论:对于拒绝行根治性膀胱全切的肌层浸润性膀胱癌患者,经尿道膀胱肿瘤电切术是一种行之有效的治疗方法,手术创伤小,恢复快,并发症少,手术后患者生活质量有保障。对于保留膀胱的患者,在经尿道膀胱肿瘤电切术(TURBT)后需要定期复查并结合膀胱灌注及辅助化疗,可以达到较理想的效果。
[Abstract]:Objective: to analyze the therapeutic effect and prognosis of patients with bladder cancer who were diagnosed as invasive bladder cancer by pathology and refused to undergo radical cystectomy after transurethral resection of bladder tumor. It provides a new idea for the diagnosis and treatment of intramuscular invasive bladder cancer. Methods: from January 2011 to December 2015, 110 patients with invasive bladder cancer were diagnosed pathologically and refused to undergo radical cystectomy after transurethral resection of bladder tumor (TURBT). There were 79 males and 31 females. The average age was 67.3 years (38 / 89 years). The tumor was excised completely at the time of operation, reaching the depth of the extramural fat layer of the bladder and extending to the normal 0.5-1.0cm mucosa around the bladder tumor. Postoperative intravesical perfusion therapy was performed in 10 patients, including 10 patients with GC regimen for 4 cycles of systemic adjuvant chemotherapy, 5 patients with internal iliac artery chemotherapy and 5 patients with postoperative loss of follow-up. Results: 110 patients underwent electroresection of bladder tumors with an average operation time of 43 minutes, an average intraoperative blood loss of 15 ml, no serious complications, and an average postoperative hospital stay of 7.7 days. After operation, 10 patients were treated with intravesical instillation, 10 patients were treated with 4 cycles of systemic chemotherapy with GC regimen, 5 patients were treated with embolization of internal iliac artery. There were 28 cases of recurrence, the recurrence rate was 26.7%, the recurrence time was 1 鈮，
本文编号：2474205
[Abstract]:Objective: to analyze the therapeutic effect and prognosis of patients with bladder cancer who were diagnosed as invasive bladder cancer by pathology and refused to undergo radical cystectomy after transurethral resection of bladder tumor. It provides a new idea for the diagnosis and treatment of intramuscular invasive bladder cancer. Methods: from January 2011 to December 2015, 110 patients with invasive bladder cancer were diagnosed pathologically and refused to undergo radical cystectomy after transurethral resection of bladder tumor (TURBT). There were 79 males and 31 females. The average age was 67.3 years (38 / 89 years). The tumor was excised completely at the time of operation, reaching the depth of the extramural fat layer of the bladder and extending to the normal 0.5-1.0cm mucosa around the bladder tumor. Postoperative intravesical perfusion therapy was performed in 10 patients, including 10 patients with GC regimen for 4 cycles of systemic adjuvant chemotherapy, 5 patients with internal iliac artery chemotherapy and 5 patients with postoperative loss of follow-up. Results: 110 patients underwent electroresection of bladder tumors with an average operation time of 43 minutes, an average intraoperative blood loss of 15 ml, no serious complications, and an average postoperative hospital stay of 7.7 days. After operation, 10 patients were treated with intravesical instillation, 10 patients were treated with 4 cycles of systemic chemotherapy with GC regimen, 5 patients were treated with embolization of internal iliac artery. There were 28 cases of recurrence, the recurrence rate was 26.7%, the recurrence time was 1 鈮，
本文编号：2474205
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