Thiel U, Wagner S
Z Urol Nephrol. 1980 Apr;73(4):267-77.
On principle every vesical tumour should be resected at first transurethrally. The TUTUR allows an exact establishment of the penetration depth of the tumour. The transurethral electro-resection gives representative tissue for the histological examination. For the majority of the superficially infiltrating tumours it represents the method of choice with curative aim. In the treatment of the progressed vesical carcinomas the TUTUR with palliative aim gives immense advantages. Using the developing paravesical inflammation wall the following secondary (and more) resection into the perivesical fatty tissue is possible. The intervention can be repeated at every time it is not mutilating does not cause any stoma problems or metabolic derangements as after discharge of the urine and may be suggested to patients in a general condition which forbids an open surgical intervention. The resection can improve the quality of the patient's life for a long time without great stress and thorough changes of the life habits of old people. However the resection treatment will be successful only then, when it will be performed by an experienced (in transurethral operations) operator with a technically good instrumentarium.
原则上,每例膀胱肿瘤都应首先经尿道切除。TUTUR(经尿道超声引导下经膀胱肿瘤整块切除术)能够精确确定肿瘤的浸润深度。经尿道电切可获取具有代表性的组织用于组织学检查。对于大多数浅表浸润性肿瘤而言,它是具有治愈目的的首选方法。在进展期膀胱癌的治疗中,以姑息为目的的TUTUR具有极大优势。利用逐渐形成的膀胱旁炎症壁,后续可进一步(甚至更多次)切除至膀胱周围脂肪组织。只要该干预不会造成毁伤、不引起任何造口问题或代谢紊乱(如排尿后出现的情况),就可随时重复进行,并且对于身体状况不允许进行开放性手术干预的患者也可采用。这种切除术能够在不造成巨大压力以及无需老年人彻底改变生活习惯的情况下,长期改善患者的生活质量。然而,只有当由经验丰富的(经尿道手术方面)操作者使用技术良好的器械进行切除治疗时,才会取得成功。