膀胱憩室內銩雷射完整切除手術-案例報告
許軒豪1、林雍偉1,2
臺北醫學大學˙市立萬芳醫院泌尿科1、臺北醫學大學泌尿科2
Thulium laser en bloc resection for intra-diverticulum bladder tumor – A case report
Syuan-Hao Syu1 ,Yung-Wei Lin1,2
Department of Urology, Wan Fang Hospital, Taipei Medical University1
Department of Urology, School of Medicine, College of Medicine, Taipei Medical University2
Introduction: We present one case who had intra-diverticulum bladder tumor which was totally endoscopic resected by thulium laser en bloc resection and discuss the safety of surgical method and postoperative prognosis.
Case: A 84 year-old man who was diagnosed as bladder tumor due to painless hematuria. After flexible cystoscopy was done, the tumor was located within bladder diverticulum. Due to elder age and high anesthesia risk due to his comorbidity, thulium laser en bloc resection was performed for tumor resection. No perforation was noted during operation. The final pathology report also revealed no tumor invasion of detrusor muscle invasive with free-margin.
Discussion: Within all bladder tumor, intra-diverticulum bladder tumor is accounted for approximately 1 %. Lack of muscle of bladder diverticulum may result in urinary stasis which will increase the risk of tumor developing. For non-muscle-invasive intravesical bladder tumor, we usually used surgical intervention such as transurethral resection of bladder tumor, diverticulectomy, and partial or radical cystectomy. Endoscopic resection of intra-diverticulum bladder tumor is difficulty performed due to easily perforation. The good result which including no complications and good prognosis of thulium laser en bloc resection of intra-diverticulum bladder tumor give us further safety choice of surgical method for choosing.
Conclusion: In our case, laser en bloc tumor resection is one good choice which may have equal effect compared to open or endoscopic diverticulectomy..