表淺性膀胱癌鈥激光切除療效觀察.pdf

1、浙江大學醫(yī)學院碩士學位論文表淺性膀胱癌鈥激光切除療效觀察姓名：胡林義申請學位級別：碩士專業(yè)：外科學（泌尿外科）指導(dǎo)教師：杜傳軍20080401AbstractPURPoSE：Bladdercancerisoneofthemostcommonmalignancies，andtheHoImiumlaSerisanewmodali吼deVelopedquicklytheseyears，oftreatmentofbladdercancerWee

2、valuatedthetre咖entsofholmiumlaserresectionofsuperficialbladdercancerinourhospitalMATEIUALSANDM匝THODS：52patientsofsuperficialbladdercarcinomawereselected療0mtheUrologydepanmentofseconda幣liatedhoSphlofZhejiangUniVerSityColl

3、egeofmedicine白omJanua拶2005toDecember2006Therewere42malepatientsand10femalewithanaVerageageof681me伊。訓|hhasbeensinglein32andmultiplein20Thediameterofthetumorwas05~45cmwiththepath0109ygradeG1～G2andclinicalstageTl～T2Therewer

4、e36casesalongwith0therdiseasessuchaschronicbronchitisaVecpulmona拶heartdisease，hypertensioniSchemicheandiseasc，diabetes，bladderStonesandBPHWithadoptionofepiduralanesthesia，setin1ithotomyposition，perfusedbysalinei幣gation，H

5、oImiumlaser’sene聊par鋤eterSof10t015J，舶quencybe咻een20Hzt030Hz，power舶m20Wt045Wjweresectedthebladdertumorwithl～2cmmarginofnormalbladdermucosa，witheachcasecarriedoutofconVentionalchemotherapybladderirrigation0fMitomycinRESUl月

6、S：TheprocedurewereperformedsuccessfhlinaIlcaseswiththeresectiontimeaboutl5～50min，meallof25min，wi也antheStonescrushed，noobturatornervereflexestakingplace，nocascofureterals仃icture，nopoStoperatiVeurina巧ex仃aVasation，nobleedin

7、g，noseconda眄cardiov硒cularandcerebroVascularaccidentSandotherseriouscomplications0ccurringNoneedforbladderwashingpostoperatiVely，鋤dthecatheterretentiontimerange行om1to4d，3d0naVerageandthehospitalizedtimepoStoperatiVelyfrom

8、3to6d，aVerageof4dPostoperatiVepathologyshowedt瑚1sitionalcellcarcinomaIandIIWithin1year’sfollow—up，there’snourethralstrictureormyelosuppressjoncaSesoccum：d，withfourcasesofrecullrence(recurrcncerateof8％)，卸donecaSeofinsitur

9、ecurrcnce(recurrencerateof2％)Conclusions：IthasbeendemonstratedthatHolmiumJasertherapyisproVidedwithadVa玎tagesofsimpleprocedure，shortoperationtime，lessshocktothepatients，觚dissuitablefortreatmentofpatientsinelderage，witlln