鈥雷射及完整性腫瘤方法於膀胱癌腫瘤切除之應用：先期報告
羅啟文、張尚仁、謝政興、楊緒棣
台北慈濟泌尿科 外科部 泌尿科
A preliminary report:
The application of Ho-YAG Laser in TURBT with ENBLOC METHOD
Chi-Wen, Lo, Shang Jen, Chang, Chang-Hsin Hsieh, Shei-Dei Yang
Divisions of Urology, Department of Surgery, Taipei Tzu Chi Hospital, New Taipei, Taiwan
Purpose: The traditional TURBT surgery still have several drawbacks include fragmentation, cauterization effect and easily disorientation. In here, we reviewed our patients receiving laser en bloc TURBT to compared the traditional TURBT with the feasibility, oncology outcome and complication rate.
Materials and Methods: We reviews patients newly diagnosed and received TURBT surgery in our hospital from 2011 to 2014. Patients who were loss of following up/ under unresectable status were all excluded. The age, body weight, height and sex were all recorded. The number, grade and stage of tumor were all recorded. Also, the complication during the operation were also reviewed based on medical record.
Results: From 2011 to 2014, there were 10 patients received laser TURBT and 52 patients received traditional TURBT surgery. The detrusor muscle harvest rate was 91.6% in Laser TURBT group and 77.4% in traditional TURBT group (p= 0.44). The mean following time was 25.5 months (Median 23.1 months). The total recurrence rate was 11.9% (2/9) in Laser TURBT group and 22.4%(13/58) in cTa/ cT1/ cT2 group. In comparison the recurrence rate in T1/ Ta group, the detrusor muscle (+) group has lower recurrence rate in both laser TURBT group (25.0%) and traditional TURBT group (24.2%) than the detrusor muscle (-) group (40%). All the procedures have no complication recorded.
Conclusions: The application of laser with En-bloc method in TURBT is a good alternative which could increase the diagnosis accuracy and lower the recurrence rate.