Objective To evaluate the safety and efficacy of 1 470 nm diode laser local excision in the treatment of elderly patients with high-risk bladder cancer. Methods We retrospectively re-viewed the clinical data of 48 elderly patients with high-risk bladder cancer,who were treated by 1 470 nm diode laser local excision in our hospital from Mar.2014 to Mar.2016.Eighteen cases were diagnosed as muscle invasive bladder cancer and 30 cases were T1high grade urothelial carcinoma by postoperative pathology. Results All operations were completed successfully.The average operat-ing time was (46.3±9.6)min,and hemorrhage volume during surgery was (13.6±2.8)ml.The av-erage bladder irrigation time and indwelling catheterization time was (2.6±0.5)d,(7.2±1.5)d,re-spectively.During the follow-up period of 1 2-3 6 months postoperatively,eight cases were detected recurrence by image and two cases were treated by artery embolization because of hematuria. Con-clusions For the elderly patients with high-risk bladder cancer,1 470 nm diode laser enucleation is a safe and effective operation method.It can effectively control the tumor,delay the progression of the disease,reduce tumor bleeding and related complications,improve the quality of life of the elderly patients.%目的 探讨1470 nm半导体激光局部切除在治疗老年高危膀胱癌中的临床价值.方法 回顾性分析2014年3月至2016年3月在我院行1470 nm半导体激光膀胱癌膀胱局部彻底切除的48例老年高危膀胱癌患者的临床资料,患者年龄75.3~92.6岁,平均82.5岁;术后病理证实18例为肌层浸润性膀胱癌,30例为非肌层浸润性高级别尿路上皮膀胱癌.结果 48例患者均顺利完成手术,平均手术时间(46.3±9.6)min,术中出血(13.6±2.8)ml,术后膀胱冲洗(2.6±0.5)d,留置尿管(7.2±1.5)d,1例发生灌注液外渗,经穿刺引流治愈.随访12~36个月,8例影像学检查复发,2例出现明显肉眼血尿行介入止血治疗.结论 采用1470 nm 半导体激光局部彻底切除治疗老年高危膀胱癌安全,能有效控瘤、延缓疾病进展、降低肿瘤出血及相关并发症,改善老年患者生活质量.
展开▼
