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asbryobvrz · Wysłany: Czw 18:23, 24 Mar 2011

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Transurethral resection of bladder tumor treatment of 38 cases

Pipe, water balloon 2OraL, continuous bladder irrigation slowly, to be no blood in urine to stop flushing, catheter removal at postoperative 3 ~ 5d. Conventional surgery control group. 7d were started after bladder instillation of mitomycin, 1 week, a total of 8 times,[link widoczny dla zalogowanych], after 1 month,[link widoczny dla zalogowanych], once every 2 years, reviewed every 3 months during 1 cystoscopy. 2 Results 5l 1 bladder tumors were removed successfully. Operation time l5 ~ 55min, less bleeding, clear vision, no blood transfusion cases transurethral resection. Persistent postoperative follow-up l ~ 2 years, 3N tumor recurrence, tumor resection successfully performed again. TURBT group, 8 patients had intraoperative bladder perforation threshold, indwelling catheter l week, to do special treatment, no other complication. Control group of patients, the average length of stay l2.56 days, operative time 96.56rain, blood loss 200 ~ 300mL, the number of control patients who were followed up for tumor recurrence and no significant difference between the groups. Superficial bladder cancer accounts for 3 to discuss two-thirds of bladder cancer, so far, transurethral resection of bladder tumor perfusion is still considered the best cure for superficial bladder cancer program. By transurethral resection of superficial bladder cancer with shorter operative time, patient trauma, less pain,[link widoczny dla zalogowanych], were easy to accept, and rapid recovery, there is no risk of cancer and other advantages of the abdominal wall planting. TURBT patients for the following: (1) non-invasive superficial bladder tumor patients; (2) tumor less than 3cm in diameter; (3) If the tumor is pedunculated, the pedicle diameter and lcm below, even if the tumor diameter of more than 3cm, ; (4) the tumor is already advanced, patients with poor general condition, severe bleeding, have not those who underwent open surgery; (5), larger tumor, already more than T3, but with severe heart and lung disease and other diseases, can not tolerate partial cystectomy or radical cystectomy were. Line before TURBT on tumor size, quantity,[link widoczny dla zalogowanych], grade and stage all to master. B-cancer screening is the preferred method, it can learn abdominal organ metastasis; pelvic CT or MRI, can help determine whether the depth of tumor invasion and pelvic lymph node metastasis. Intravenous urography can understand whether the water on the urinary tract, except the renal pelvis and ureter cancer; cystoscopy can be directly found in tumor size, number, location, whether the bleeding, whether pedicle, which will help to establish a reasonable cure program, the choice of and evaluation of surgical methods have important prognostic value. The depth of tumor resection to achieve deep muscle is more appropriate. Different parts of the tumor using different cutting methods: (1) triangle area and the bottom of the bladder tumors using antegrade excision; (2) of bladder tumors using the top electrode lateral movement of cutting; (3) resection of bladder wall the tumor, prone to obturator reflex, may be appropriate to shorten the distance between cutting ring extended to reduce the current intensity and reduce water-filled bladder, rapid short-distance cut; (4) anterior resection of bladder tumors, the assistant in the upper abdomen bladder area down to the anterior wall of the bladder pressure, so that the parts of the tumor down to facilitate their removal; (5) when the tumor is located around the ureteral orifice, ureteral 1:1 and sometimes not visible, in order to completely remove the tumor, the tumor should be with the ureteral orifice resection (less than wall segments and l / 3 does not appear regurgitation). To minimize coagulation, in order to avoid scar formation and ureteral stenosis. TURBT intravesical injection to 100 ~ 150mL water is appropriate, when the bladder mucosal folds disappear, and the bladder muscle has not been fully extended, the relative wall thickness, tension and safer resection. Too much liquid can the bladder wall thinning, high incidence of bladder perforation. Vulnerable to recurrence of bladder cancer patients. Residual bladder cure can kill tumor cells and decrease the recurrence rate and prolong relapse every question, but also to prevent tumor progression, is the superficial bladder cancer after conventional adjuvant therapy TuRBT.