Ren X S, Fu W J, Wang Y P, Wang C Y, Zhang X
Department of Urology, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2017 Jul 25;97(28):2205-2207. doi: 10.3760/cma.j.issn.0376-2491.2017.28.010.
To discuss the experience of diagnosis and treatment of transurethral resection of paraganglioma in urinary bladder. This retrospective study included 8 patients who underwent transurethral resection of paraganglioma in bladder from October 2009 to April 2015. Four males and 4 females were enrolled. The age ranged from 33 to 77 years (mean: 50.4 years), with a clinical course from 1 month to 8 years. Five cases presented with hypertension and 4 had high level of noradrenaline in blood. Preoperative ultrasound, CT and MRI were performed on every patient and the results showed all tumors were solitary and limited in bladder wall. Six patients received conventional transurethral electroresection and the other 2 patients received transurethral resection with thulium laser.Postoperative follow-up of each case was recorded. All tumors were excised successfully without converting to open surgery. The maximum diameter of tumors ranged from 1.0 to 4.5 cm (mean: 2.3 cm), operative time varied from 15 to 35 min (mean: 28.1 min) and intraoperative blood loss ranged from 20 to 50 ml (mean: 31.9 ml). The variation of blood pressure during operation was 10 to 160 mmHg (mean: 66.3 mmHg). The loss of follow-up occurred in 1 case, tumor recurrence occurred in 1 case at 3 months after surgery and the follow-up data of other patients was normal. The diagnosis of paraganglioma in bladder should be combined with clinical symptoms, biochemical and imaging examination for some cases. Transurethral resection of tumors is a safe and reliable surgical manner.
探讨膀胱嗜铬细胞瘤经尿道切除术的诊治经验。本回顾性研究纳入了2009年10月至2015年4月期间接受膀胱嗜铬细胞瘤经尿道切除术的8例患者。其中男性4例,女性4例。年龄范围为33至77岁(平均50.4岁),病程为1个月至8年。5例患者出现高血压,4例患者血液中去甲肾上腺素水平升高。对每位患者均进行了术前超声、CT和MRI检查,结果显示所有肿瘤均为单发,局限于膀胱壁。6例患者接受了传统经尿道电切术,另外2例患者接受了铥激光经尿道切除术。记录了每例患者的术后随访情况。所有肿瘤均成功切除,未转为开放手术。肿瘤最大直径为1.0至4.5 cm(平均2.3 cm),手术时间为15至35分钟(平均28.1分钟),术中出血量为20至50 ml(平均31.9 ml)。术中血压波动范围为10至160 mmHg(平均66.3 mmHg)。1例患者失访,1例患者术后3个月肿瘤复发,其他患者随访数据正常。膀胱嗜铬细胞瘤的诊断应结合临床症状、生化及影像学检查。经尿道肿瘤切除术是一种安全可靠的手术方式。