Hata M, Nakajima F, Takao M, Odajima K, Ieda K, Fujioka T, Nakamura H
Department of Urology, School of Medicine, Keio University.
Hinyokika Kiyo. 1987 Nov;33(11):1794-9.
One invasive and 4 superficial bladder cancers were treated by local injection of absolute ethanol through an endoscope. With the patient placed in the lithotomy position, an endoscope was introduced after mucosal anesthesia with xylocaine jelly. According to the usual manner of retrograde catheterization, a 23G syringe needle attached to a 5F ureteral catheter was advanced into the base of the tumor and through the needle absolute ethanol was injected. This treatment is characterized by endoscopic delivery of ethanol as with sclerotherapy for esophageal varices to obtain a potent necrotizing effect as achieved by transcatheter embolization of ethanol for the treatment of renal cell carcinoma. As a rule, this technique does not require any anesthesia other than mucosal anesthesia with xylocaine jelly and can be done repeatedly and very easily, thus having a high cost effectiveness. This treatment serves as a good palliative therapy for invasive bladder cancers, because of its rapid achievement of hemostasis and reduction of the tumor masses. Furthermore, this treatment is just as effective as standard transurethral resections to eradicate superficial bladder cancer, even though the treatment may have to be repeated.
1例浸润性膀胱癌和4例浅表性膀胱癌通过内镜局部注射无水乙醇进行治疗。患者取截石位，用利多卡因凝胶进行黏膜麻醉后插入内镜。按照逆行插管的常规方法，将连接5F输尿管导管的23G注射器针头推进至肿瘤基底部，并通过针头注射无水乙醇。这种治疗方法的特点是通过内镜输送乙醇，如同治疗食管静脉曲张的硬化疗法一样，以获得如同经导管注入乙醇栓塞治疗肾细胞癌时所达到的强大坏死效果。通常，除了用利多卡因凝胶进行黏膜麻醉外，该技术不需要任何其他麻醉，并且可以非常容易地重复进行，因此具有很高的成本效益。这种治疗方法对浸润性膀胱癌是一种很好的姑息治疗方法，因为它能迅速实现止血并缩小肿瘤肿块。此外，这种治疗方法在根除浅表性膀胱癌方面与标准经尿道切除术同样有效，尽管可能需要重复治疗。
