周荣升 郁全胜 臧光辉

    [摘要] 目的 探讨经尿道荧光膀胱镜下膀胱肿瘤整体切除术治疗膀胱肿瘤的临床方法。 方法 选取2014年1月～2015年12月在徐州市中心医院诊治的40例膀胱肿瘤患者。采用骶管阻滞麻醉，共切除肿瘤45枚，其中单发肿瘤36例，肿瘤直径0.5～2 cm，均位于膀胱后壁或颈口位置。先荧光膀胱镜下观察膀胱内肿瘤大小及部位，再用等离子沿肿瘤近端切开膀胱壁全层达膀胱外脂肪，然后向远端全层切除，最后切除肿瘤远端完整切除肿瘤及其基底部膀胱全层。 结果 40例患者均顺利完成手术，手术时间10～40 min，平均(23.95±8.39)min，术中出血量极少，术后无继发性出血，术后肿瘤病理分期T1期34例，T2期6例，术后随访12～24个月，平均(14.89±1.97)个月，无肿瘤复发。 结论 经尿道荧光膀胱镜下膀胱肿瘤整体切除术能完整切除肿瘤及肿瘤基底，并且荧光下可以对可疑膀胱壁进行预防性切除，手术效果确切。

    [关键词] 膀胱尿路上皮癌；荧光膀胱镜；膀胱肿瘤整体切除术；临床观察

    [中图分类号] R737 [文献标识码] A [文章编号] 1673-7210(2017)05(c)-0080-04

    [Abstract] Objective To investigate the clinical method of transurethral resection of bladder tumor with cystoscopy in the treatment of bladder tumor. Methods From January 2014 to December 2015， 40 patients with bladder cancer who were treated at Xuzhou Central Hospital were observed. All the patients were treated with sacral obstruction anesthesia. 45 cases of tumor were removed， including 36 cases of tumor were single tumor， and the tumor diameter was 0.5～2 cm， which were located in the posterior wall of the bladder or the location of the neck. Firstly， the tumor size and location of the bladder were observed by fluorescent cystoscopy. Then the bladder wall full of bladder fat was cut by the plasma along the tumor proximal ......