經尿道解剖性膀胱腫瘤剝離術
許志呈, 林威佑
佛教慈濟醫療財團法人玉里慈濟醫院 泌尿科
Transurethral anatomical dissection of bladder tumor
Chih-Chen Hsu, Wei-Yu Lin,
Department of Urology, Buddhist Tzu Chi Yuli Hospital
Purpose
We introduce a better technique than conventional transurethral resection of bladder tumor (TURBT) for diagnosis and treatment of bladder tumor. The skill is easily-learned and performed with monopolar electrode cutting loop.
Material and method
From January, 1st 2017 to October, 30th 2017, transurethral anatomical dissection of bladder tumor was performed on 8 patients diagnosed with bladder tumor. This technique includes incision at the margin of the tumor and dissection beneath the tumor, just inside the detrusor muscle. We report the complications, pathology results, and presence of muscular layer in the specimen.
Result
Eight patients underwent the new procedure. Two of them have large tumor burden more than 50g. One patient has adenocarcinoma and seven of them have urothelial carcinoma. Four patients are muscle-invasive bladder cancer. None of them has major complications, such as death, blood transfusion, urosepsis, and bladder rupture. All specimens contain detrusor muscle.
Conclusion
Transurethral anatomical dissection of bladder tumor is a simple, safe and effective method to treat and diagnose bladder cancer. The advantages include En bloc resection, identifying the depth of cut, harvesting complete histological structure in pathology, less complications, and better surgical view.