Nieder Alan M, Manoharan Murugesan
Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
ScientificWorldJournal. 2006 Jun 7;6:2626-31. doi: 10.1100/tsw.2006.405.
Non-muscle invasive bladder cancers are a heterogeneous group of cancers whose spectrum includes low grade Ta lesions and high-grade T1 lesions. Accurate staging and grading during initial evaluation and TUR ensures appropriate treatment and prevents the risk of understaging. TUR should be ideally performed under spinal anesthesia, with a continuous flow video resectoscope to maintain a stable bladder capacity, and a video monitor. The entire bladder must be visualized, with both 30- and 70-degree lenses, and all abnormal areas must be resected, with separate biopsies from each tumor's base. Repeat TUR is recommended for all high grade tumors and T1 tumors, especially if muscle was not present in the initial specimen. Immediate instillation of single dose chemotherapy agents following TUR is highly recommended to reduce the risk of tumor recurrences.
非肌肉浸润性膀胱癌是一组异质性癌症，其范围包括低级别Ta病变和高级别T1病变。在初始评估和经尿道膀胱肿瘤切除术（TUR）期间进行准确的分期和分级可确保适当的治疗并防止分期不足的风险。理想情况下，TUR应在脊髓麻醉下进行，使用连续冲洗式视频电切镜以维持稳定的膀胱容量，并配备视频监视器。必须使用30度和70度镜头观察整个膀胱，所有异常区域都必须切除，并从每个肿瘤的基底单独取材活检。对于所有高级别肿瘤和T1肿瘤，尤其是初始标本中未发现肌肉组织的情况，建议重复进行TUR。强烈建议在TUR后立即灌注单剂量化疗药物以降低肿瘤复发风险。
