Objective: To discuss the experience of diagnosis and treatment of transurethral resection of paraganglioma in urinary bladder. Methods: This retrospective study included 8 patients who underwent transurethral resection of paraganglioma in bladder from October 2009 to April 2015. Four males and 4 females were enrolled. The age ranged from 33 to 77 years (mean: 50.4 years), with a clinical course from 1 month to 8 years. Five cases presented with hypertension and 4 had high level of noradrenaline in blood. Preoperative ultrasound, CT and MRI were performed on every patient and the results showed all tumors were solitary and limited in bladder wall. Six patients received conventional transurethral electroresection and the other 2 patients received transurethral resection with thulium laser.Postoperative follow-up of each case was recorded. Results: All tumors were excised successfully without converting to open surgery. The maximum diameter of tumors ranged from 1.0 to 4.5 cm (mean: 2.3 cm), operative time varied from 15 to 35 min (mean: 28.1 min) and intraoperative blood loss ranged from 20 to 50 ml (mean: 31.9 ml). The variation of blood pressure during operation was 10 to 160 mmHg (mean: 66.3 mmHg). The loss of follow-up occurred in 1 case, tumor recurrence occurred in 1 case at 3 months after surgery and the follow-up data of other patients was normal. Conclusions: The diagnosis of paraganglioma in bladder should be combined with clinical symptoms, biochemical and imaging examination for some cases. Transurethral resection of tumors is a safe and reliable surgical manner.
目的: 探讨膀胱副神经节瘤(PUB)的诊断及经尿道肿瘤切除术的治疗经验。 方法: 回顾性分析我院自2009年10月至2015年4月行经尿道切除术治疗的8例膀胱副神经节瘤患者的临床资料。男4例,女4例,年龄37~77岁,平均50.4岁,病程1个月至8年余。高血压5例,血去甲肾上腺素升高4例。所有患者术前均行超声、CT或磁共振成像(MRI)检查,提示均为单发肿瘤且局限于膀胱壁内。手术方法采用经尿道肿瘤切除术,6例为经尿道电切术,2例为经尿道激光切除术。所有患者均进行术后随访。 结果: 8例手术均顺利完成,无中转开放手术。肿瘤最大径1.0~4.5 cm,平均2.3 cm;手术时间15~35 min,平均28.1 min;手术出血量20~50 ml,平均31.9 ml。患者术中收缩压波动幅度10~160 mmHg(1 mmHg=0.133 kPa),平均66.3 mmHg。随访中1例患者失访,1例术后3个月肿瘤复发,其余6例随访结果均正常。 结论: 诊断膀胱副神经节瘤要结合病史、生化检查及影像学检查进行综合分析,对于部分患者,经尿道肿瘤切除术是一种安全、可靠的手术方式。.
Keywords: Paraganglioma; Transurethral resection; Urinary bladder neoplasms.