莊光達^1,2、黃一勝^1,2,3 、蔡德甫^1,2

¹新光吳火獅紀念醫院  外科部 泌尿科

²輔仁大學醫學院  泌尿學部

³台北醫學大學   泌尿學部

Guang-Dar Juang^1,2、Thomas I-sheng Hwang^1,2,3、Te-Fu Tsai^1,2

¹Division of Urology, Department of Surgery, Shin-Kong WHS Memorial Hospital, Taipei,Taiwan
² School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan

³ School of Medicine, Taipei Medical University, Taipei, Taiwan

 

Purpose: We describe the preliminary experience of a new method by Thulium laser for transurethral resection of CIS or diffuse sessile bladder tumors.

Materials and Methods: From September 2014 to December 2015, 7 patients (6 males and 1 female) newly diagnosed with having diffuse sessile bladder tumors with or without ureteral orifice involved were selected by TUR-BT of Thulium Laser. A 10-20 watts Thulium laser power was used to incise bladder tumors by 300-microm fiber through resectoscope. Mean tumor diameter was 5.5cm (range 3.5-9.0). Results: All patients were treated successfully in one secession. No patients experienced detrusor nerve reflection intra-operatively and no bladder perforation in dome-located neoplasm. Mean operative time was 55 min (range 30 -100). Tumors involved ureteral meatus were noted in 3 patients. The orifice was sharply excised without subsequent evidence of stenosis. The mean follow-up time was 8.4 months. Tumor recurrences were found in two patients in 6 and 12 months postoperatively.

Conclusions: In our limited experience, Thulium laser TURBT is a reliable therapy with minimal morbidity for selected patients of diffuse bladder tumors with ureteral orifice involved or CIS.