Gao Xu, Ren Shancheng, Xu Chuanliang, Sun Yinghao
The Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China.
BJU Int. 2008 Nov;102(9):1115-8. doi: 10.1111/j.1464-410X.2008.07814.x. Epub 2008 Jun 19.
To present our initial experience of thulium laser resection via a flexible cystoscope for recurrent non-muscle-invasive bladder cancer (ThuRBT), as transurethral resection for bladder tumour (TURBT) is regarded as the reference standard for treating this disease, but alternative laser resection or ablation is suitable especially for recurrent tumours.
From January 2005 to October 2005, 32 patients with early recurrent bladder tumour (recurrent within a year after TURBT) were treated with ThuRBT via a flexible cystoscope. The follow-up included urine analysis, ultrasonography and cystoscopy every 3 months.
All patients were treated successfully with ThuRBT in one session, with no bladder haemorrhage, obturator nerve reflex or vesicle perforation. Randomized biopsies taken after surgery on and adjacent to the resection surface revealed no residual tumours. The mean (range) tumour diameter was 1.5 (0.5-3) cm and the mean operative duration was 25 (15-35) min. During the first year of follow-up, local and heterotopic recurrences were found in three and six patients, respectively. The accumulated recurrence rates at 3, 6 and 12 months were 9%, 22% and 28%, respectively.
ThuRBT is a reliable therapy with minimal morbidity and invasiveness for selected patients with bladder cancer.
介绍我们通过软性膀胱镜进行铥激光切除术治疗复发性非肌层浸润性膀胱癌（ThuRBT）的初步经验，因为经尿道膀胱肿瘤切除术（TURBT）被视为治疗该疾病的参考标准，但替代性激光切除或消融术尤其适用于复发性肿瘤。
2005年1月至2005年10月，32例早期复发性膀胱肿瘤（TURBT术后1年内复发）患者通过软性膀胱镜接受ThuRBT治疗。随访包括每3个月进行尿液分析、超声检查和膀胱镜检查。
所有患者均一次成功接受ThuRBT治疗，无膀胱出血、闭孔神经反射或膀胱穿孔。术后在切除表面及其相邻部位进行随机活检，未发现残留肿瘤。肿瘤平均直径（范围）为1.5（0.5 - 3）cm，平均手术时间为25（15 - 35）分钟。在随访的第一年，分别有3例和6例患者出现局部复发和异位复发。3、6和12个月时的累积复发率分别为9%、22%和28%。
对于选定的膀胱癌患者，ThuRBT是一种可靠的治疗方法，发病率和侵袭性极低。
