膀胱癌是目前泌尿外科最常见的恶性肿瘤之 一。世界范围内在所有恶性肿瘤中排第十二位,在 泌尿系统恶性肿瘤位居第二位[1] 。膀胱癌每年新发病 例为 549,393 例,死亡病例为 199,922 例[2] 。其中非 肌层浸润性膀胱癌约占膀胱癌的 70%[3] 。非肌层浸润 性膀胱癌的治疗方法以手术治疗为主,辅助膀胱腔 内灌注治疗。2019版中国泌尿外科和男科疾病诊断 治疗指南中指出非肌层浸润膀胱癌的手术治疗主要 的手术方式为经尿道膀胱肿瘤切除术、经尿道膀胱 肿瘤整块切除术、膀胱部分切除术、根治性膀胱切 除术[4] 。经尿道膀胱肿瘤激光切除手术在泌尿外科已 经得到较为广泛的应用。而 1470激光作为一种新型 的激光在临床上应用仍有一些问题需要详细探讨。 因此,本文对 1470激光治疗非肌层浸润膀胱的临床 进展进行综述。
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[4] 黄健.中国泌尿外科和男科疾病诊断治疗指南:2019版.北京:科学 出版社,2020:44-45 [5] Kramer MW, Wolters M, Abdelkawi IF, et al. Transurethral en bloc resection of non-muscle invasive bladder cancer. What is the state of the art?[J]. Urologe A, 2012,51 (6):798-804
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[13] 杨成林,王尉,肖远松,等.肿瘤基底黏膜下吉西他滨溶液扩张辅 助 1470 nm激光经尿道膀胱肿瘤整块切除术治疗非肌层浸润性 膀胱癌[J].实用医学杂志,2019,35(01):61-65
[14] 任晓磊,郭俊生,崔向宇,等.1470 nm 激光经尿道汽化切除高龄 高危浅表性膀胱癌的疗效观察[J].中华腔镜泌尿外科杂志(电子 版),2017,11(06):416-418
[15] 文瀚东,王涛,潘铁军,等.1470 nm 半导体激光局部切除治疗老 年高危膀胱癌的临床价值探讨[J].现代泌尿生殖肿瘤杂志,2018, 10(01):13-15
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单戈,亢渐,牛吉瑞. 1470激光治疗非肌层浸润性膀胱癌的研究进展[J]. 泌尿外科杂志(电子版),2021,13(1):8-10. DOI:10.3969/j.issn.1674-7410.2021.01.003.
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膀胱癌是目前泌尿外科最常见的恶性肿瘤之一。世界范围内在所有恶性肿瘤中排第十二位,在泌尿系统恶性肿瘤位居第二位[1] 。膀胱癌每年新发病 例为 549,393 例,死亡病例为 199,922 例[2] 。其中非 肌层浸润性膀胱癌约占膀胱癌的 70%[3] 。非肌层浸润 性膀胱癌的治疗方法以手术治疗为主,辅助膀胱腔 内灌注治疗。2019版中国泌尿外科和男科疾病诊断 治疗指南中指出非肌层浸润膀胱癌的手术治疗主要 的手术方式为经尿道膀胱肿瘤切除术、经尿道膀胱 肿瘤整块切除术、膀胱部分切除术、根治性膀胱切 除术[4] 。经尿道膀胱肿瘤激光切除手术在泌尿外科已 经得到较为广泛的应用。而 1470激光作为一种新型 的激光在临床上应用仍有一些问题需要详细探讨。 因此,本文对 1470激光治疗非肌层浸润膀胱的临床进展进行综述。
1 对于非肌层浸润性膀胱癌是解剖性整块切除还是分块切除?
2 1470 激光治疗非肌层浸润性膀胱癌的疗效观察
3 1470 激光经尿道膀胱肿瘤切除术是否可以实现住院手术日间手术化?
4 1470 激光经尿道膀胱肿瘤切除术是否需要进行二次切除?
5 1470 激光膀胱肿瘤解剖性切除术的局限性
6 小结
1470激光膀胱肿瘤解剖性切除术理论上可以保 持膀胱肿瘤的完整性,这样有利于患者术后的病理 分期,同时避免肿瘤在膀胱腔内分割,有效预防膀 胱肿瘤在膀胱内种植转移。但是目前该技术仍然有 其局限性,限制其广泛应用,但是随着技术进步和 设备更新,1470 激光膀胱肿瘤切除术将不断被完 善,从而实现经尿道膀胱肿瘤激光切除术完全日间 手术化,避免患者住院,减少患者经济负担,为降 低患者二次电切的风险提供重要的技术保障。
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