Transurethral Vaporesection of Urinary Bladder Cancer by Diode Laser: A Preliminary Report

經尿道內視鏡雙極雷射汽化切除膀胱癌－初期報告

許富順(Fu-Shun Hsu) ； 杜元博(Yuan-Po Tu)

《北市醫學雜誌》 13卷4期 (2016/12) Pp. 526-532

https://doi.org/10.6200/TCMJ.2016.13.4.06

摘要

New technologies such as bipolar transurethral resection of the bladder tumors (TURBT) and laser surgery have been developed to reduce the complications of standard TURBT in treatment for superficial bladder cancer. We describe our results for six patients who underwent diode laser TURBT. We used the newly designed HookShot fiber to perform vaporesection of bladder tumors. No peri-operative complications, such as bladder perforation, obturator nerve reflux, or blood clots obstruction, were documented. Using 60-80 W laser and the Hook Shot^(TM) fiber, we can control the depth of the coagulation zone and benefit from its excellent hemostasis. Pathological analysis revealed one case of Ta disease, three of T1, one of T2a, and one of T4a disease (with invasion to the prostate). All patients are tumor-free at present. The mean disease-free interval is 21.5 months. Transurethral vaporesection by diode laser in our study seems to achieve satisfactory outcomes in the treatment of localized bladder cancer. However, future studies should investigate a larger number of patients over a longer follow-up period.

關鍵字

Urinary bladder ； urothelial carcinoma ； diode laser ； transurethral surgery

並列摘要

治療表淺的膀胱腫瘤，常施行經尿道電刀刮除術；目前已有雙極電刀刮除術或雷射等新式手術，可減少傳統電刀刮除術的併發症。我們報告了六個男性病患，進行雙極雷射汽化切除術，運用鉤形雷射光纖治療膀胱惡性腫瘤，所有的病人均無術中或術後的併發症，如膀胱破裂、血塊堵塞等。採用60至80瓦的雷射能量和鉤形雷射光纖，可以控制止血層的深度，手術過程幾乎不會出血。病理結果有一個病人屬於Ta，三個T1，一個T2a，還有一個是T4a期（因侵犯攝護腺）。所有病人追蹤至本報告發表時，仍無復發。平均無疾病期間為21.5個月。我們認為，雙極雷射汽化切除術用來治療局部膀胱癌成效令人滿意。然而，尚需更多病人數和更長的追蹤期才能進一步證實長期療效。

並列關鍵字

膀胱癌 ； 雙極雷射 ； 經尿道手術