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Objective@#To investigate the effect of transurethral resection of bladder tumor (TURBt) combined with gemcitabine intravesical instillation in the treatment of superficial bladder cancer.@*Methods@#From May 2011 to January 2016, 112 patients with superficial bladder cancer were treated in the Seventh Hospital of Ningbo.According to the digital table, the patients were randomly divided into two groups: A group was treated by TURBt, and B group was treated by TURBt combined with gemcitabine.The postoperative complications, postoperative recurrence and quality of life were compared between the two groups.@*Results@#The operation time, indwelling catheter time and hospitalization time between the two groups had no statistically significant differences (all P>0.05). The postoperative complications of the two groups were frequent urination, dysuria and hematuria.The incidence rate of complications of A group was 39.29%, which was significantly higher than that of B group (χ2=36.597, P<0.05). The recurrence rate of B group was significantly better than that of A group (χ2=8.617, P<0.05). After treatment, the quality of life of the two groups was significantly improved compared with that before treatment, and compared with that of A group, the psychology, physiology, independence, social environment, quality of life scores of B group increased more significantly (t=29.217, 25.446, 19.517, 24.339, 36.001, all P<0.05).@*Conclusion@#Transurethral resection of bladder tumor combined with gemcitabine intravesical instillation in the treatment of superficial bladder cancer can ensure the treatment effect, at the same time, it can effectively reduce the postoperative complications and the emergence of various risk, reduce postoperative recurrence and improve the quality of life of patients, it has great significance and is worthy of promotion.
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Objective To explore the clinical effect of hysteroscopic resection in the treatment of submucous myoma.Methods The clinical data of 78 submucosal myoma patients with hysteroscopic resection which were diagnosed by B ultrasound and hysteroscopy were retrospectively analyzed,including 35 cases of type O,23 cases of type Ⅰ,20 cases of type Ⅱ.Results Application of hysteroscopic resection in the treatment of type O and type Ⅰ submucosal myoma,the rate of postoperative satisfaction was 100.0％.There were 3 cases of multiple myoma in 20 cases of type Ⅱ,which were not one time of resection,and were taken the second times of resection 4 months after operation.In all operation,there was on complications,and the rate of postoperative satisfaction was 96.2％.Conclusion Hysteroscopic resection in the treatment of submucous myoma for the preservation of reproductive function and not affecting ovarian function has the advantage of less bleeding,short operation time,rapid postoperative recovery,shorter hospitalization time,and greatly improve the quality of life of patients,and has good clinical application value,it provides the effective treatment for clinical,and is worthy of clinical popularization.
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Objective To evaluate the efficacy in treatment with transurethral electrocision for prostatic cyst.Methods A total clinical documents of 15 cases prostatic cyst treated with transurethral electrocision were analyzed retrospectively.All the cases were diagnosed confirmly by ultrasonography and CT,all the cysts closed to the prostatic urethra or intrude urinary bladder and all the patients underwent transurethral electrocision.Results All operations were performed successfully with operative time of 18-60 (36 ± 13) min.No blood transfusion during and after the operation and postoperative hospital stay was (5.2 ± 2.6) d.All the patients had been followed up for 6-24 months,the clinic symptom disappeared and no complications happened.Three months after the operation,IPSS decreased from (27.2 ±5.6) scores to (7.5 ± 1.6) scores and QOL decreased from (4.5 ± 1.1 ) scores to ( 1.6 ± 0.6) scores (P＜ 0.01 ),respectively.Qmax increased from (6.8 ±2.3) ml/s to (22.4 ±4.8) ml/s (P ＜0.01).Conclusion Transurethral electrocision is an effective therapeutic measure of prostatic cyst close to the prostatic urethra or intrude urinary bladder without so many complications.
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Objective To investigate the effect of repeat transurethral resection for superficial bladder cancer. Methods One hundred and twenty patients who were newly diagnosed superficial bladder cancer were divided randomly in to two groups by mechanical sampling method,60 patients underwent second of prostate TUPKVP 4 weeks after initial transurethral and received adjuvant MMC intravesically (experiment group) and the other 60 patients received adjuvant MMC following the initial TUPKVP(control group). The two groups were followed up by cystoscopy at 3-month intervals,and then compared the recurrences between the two groups. Carcinoma in situ or muscle invasive disease were excluded from the study. Results Mean following up time was 6-24 (12.0 ±6.5) months, within the following up period,recurrence was observed in 13 (21.7%, 13/60) patients in experiment group and in 38 (63.3%,38/60)patients in control group, there was signiticantly statistical difference between the two groups (P＜ 0.01). Of all the recurrences, the recurrence rate of high grade tumor was 26.2% (11/42) in experiment group and 70.0% (35/50) in control group,the recurrence rate in experiment group was obviously less than that in control group (P ＜ 0.01). Conclusions Repeat transurethral resection can lower the recurrence of superficial bladder cancer (especially for the high grade tumor) which with initial resection, it can improve the classification of malignant rumor, and find the residual tumor, so it has value in clinical treatment.
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Objective To evaluate the outcome and the feasibility of retroperitoneal laparoscopic total nephroureterectomy with resectoscopic excision of bladder cuff for upper urinary tract transitional cell carcinoma.Methods A total of 83 patients with upper urinary tract transitional cell carcinoma underwent retroperitoneal laparoscopic total nephroureterectomy with resectoscopic excision of bladder cuff from March 2003 to July 2006.The bladder cuff was transurethrally resected for 1.5 cm in circumference from the ureteric orifice.Then the total nephroureterectomy was performed laparoscopically through retroperitoneal approach.Intraurethral catheter was indwelled for 7 days postoperatively.Adjuvant radiotherapy was given in 11 patients.Results The operation was successfully completed in all the 83 patients.The operation time was 115-205 min(mean,156 min),the intraoperative estimated blood loss was 50-150 ml(mean,80 ml),and the postoperative hospital stay was 7-11 d(mean,8.5 d).Follow-up examinations were conducted for 3-38 months(mean,10.8 months).Pathological findings revealed transitional cell carcinoma in 82 patients and moderate-to-severe atypical hyperplasia of the renal pelvis epithelium in 1 patient.Cystoscopic examinations within 12 months postoperatively found bladder tumors in 6 patients,5 of whom underwent transurethral resection of tumor and 1 of whom was given laparoscopic en bloc cystectomy with left cutaneous ureterostomy.Liver metastasis was found in 2 patients with tumor of renal pelvis(pT3G3 and pT2G3)3 months after operation.Local recurrence and lung metastasis was found in 2 patients with tumor in middle segment of the ureter(pT3G3 and pT3G2-3)6 months after operation.Bone metastasis was found in 1 patient with tumor in lower segment of the ureter(pT3G3)6 months after operation.There was 1 case of loss to follow-up,while in the remaining 71 cases no recurrence or metastasis was seen.Conclusions Retroperitoneal laparoscopic total nephroureterectomy with resectoscopic excision of bladder cuff appears to be a technically feasible operation for upper urinary tract transitional cell carcinoma,which is worthy of clinical application.
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Objective To investigate the value of transurethral electrocision of the ureteric orifice in total nephroureterectomy. Methods Transurethral electrocision in combination with lumbar incision was employed in total nephroureterectomy for treating 28 cases of transitional cell carcinoma of the renal pelvis or the upper ureter from January 2002 to September 2003 in this hospital. Transurethral electrocision of the ureteric orifice on the diseased side was performed, and then the kidney and the whole ureter were excised through a lumbar incision. A catheter was placed for 7 days postoperatively. Results The operation time was 70~95 min (mean, 81 min). No urinary leakage, severe hematuria or wound infection occurred. The length of postoperative hospitalization was 7~9 days (mean, 7.4 days). Follow-up for 8~15 months (mean, 12 months) in 28 cases found no recurrence. Conclusions Total nephroureterectomy through transurethral electrocision in combination with lumbar incision is proved to be minimally invasive and safe, with a quick recovery.
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Objective To investigate the feasibility and safety of hysteroscopic resection of large submucous hysteromyomas. Methods A retrospective study was carried out on 116 patients receiving hysteroscopic resection of submucous hysteromyoma. According to the maximal diameter of the resected myomas, the patients were divided into two groups: the control group,