目的: 总结应用VELA-铥激光低功率下整块切除浅表性膀胱肿瘤的临床应用经验, 并评估其疗效及安全性。方法: 自2017年5月至2019年5月间, 应用经尿道VELA-铥激光治疗浅表性膀胱肿瘤患者40例, 其中男性25例, 女性15例, 平均年龄64.15岁±10.35岁(49～81岁)。结果: 40例患者均在全麻下一次手术成功, 平均手术时间(25.54±7.13) min, 单个肿瘤平均切除时间为(15.9±4.24) min, 无一例因术中大出血或穿孔终止手术或改行其他术式, 未出现术中闭孔神经反射, 术后无一例出现严重的出血及感染。术后平均留置导尿时间为72 h, 术后平均膀胱冲洗时间为(12.50±4.25) h。平均随访时间(14.20±2.13)个月, 随访期1年内每3个月复查膀胱镜, 1年后每6个月复查膀胱镜, 累计复发3例, 复发率7.5%。结论: 经尿道VELA-铥激光整块切除浅表性膀胱肿瘤无严重围手术期并发症, 短期复发率低, 是治疗多发浅表性膀胱肿瘤的一种可选的安全、高效的手术方法。

Objective: To evaluate the safety and efficiency of transurethral low-power thulium laser en bloc resection of non muscle-invasive bladder tumor. Methods: total of 40 non muscle-invasive bladder tumor patients treated in our hospital from May 2017 to May 2019 were enrolled, including 25 male patients and 15 female patients with the average age of (64.15±10.35) years old. All the patients were treated with transurethral en bloc resection by using the VELA-thulium laser under low power of 15-20 W. Results: All the operations were finished successfully in one time under general anesthesia. The average time of operation was (25.54±7.13) min. No obturator nerve reflex, bladder perforation and massive bleeding was recorded intraoperatively. There was no severe urinary tract infection and blood loss postoperatively. The mean following-up time was (14.20±2.13) months. 3 cases(7.5%) had tumor recurrence. Conclusions: Transurethral low-power thulium laser en bloc resection is a safe and effective therapeutic method in treatment of non muscle-invasive bladder tumor.