Efficacy of transurethral submucosal dissection of bladder tumor combined with intraoperative bladder submucosal injection of gemcitabine in treatment of non-muscle invasive urothelial bladder cancer: a report of seven cases

Tang Ruipeng; Yi Zhengjin; Xiao Chuan; Wang Shubin; Luo Yun; Wei Xupan; Zhu Guangqiang; Wan Li

doi:10.13406/j.cnki.cyxb.003302

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Efficacy of transurethral submucosal dissection of bladder tumor combined with intraoperative bladder submucosal injection of gemcitabine in treatment of non-muscle invasive urothelial bladder cancer: a report of seven cases

Carcinoma of bladder | 更新时间：2025-10-21

- Efficacy of transurethral submucosal dissection of bladder tumor combined with intraoperative bladder submucosal injection of gemcitabine in treatment of non-muscle invasive urothelial bladder cancer: a report of seven cases
- Journal of Chongqing Medical University Vol. 48, Issue 8, Pages: 894-897(2023)
- 作者机构：
  
  攀钢集团总医院泌尿外科，攀枝花 617023
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003302
  CLC： R459.9
- Received：19 April 2023，
  
  Revised：2023-06-19，
  
  Accepted：29 June 2023，
  
  Published：28 August 2023
- 稿件说明：
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唐芮鹏,易正金,肖川,等.经尿道膀胱肿瘤黏膜下剥离术联合术中膀胱黏膜下注射吉西他滨治疗膀胱非肌层浸润性尿路上皮癌的疗效观察（附7例报告）[J].重庆医科大学学报,2023,48(8):894-897.

Tang Ruipeng,Yi Zhengjin,Xiao Chuan,et al.Efficacy of transurethral submucosal dissection of bladder tumor combined with intraoperative bladder submucosal injection of gemcitabine in treatment of non-muscle invasive urothelial bladder cancer: a report of seven cases[J].Journal of Chongqing Medical University,2023,48(8):894-897.
唐芮鹏,易正金,肖川,等.经尿道膀胱肿瘤黏膜下剥离术联合术中膀胱黏膜下注射吉西他滨治疗膀胱非肌层浸润性尿路上皮癌的疗效观察（附7例报告）[J].重庆医科大学学报,2023,48(8):894-897. DOI： 10.13406/j.cnki.cyxb.003302.

Tang Ruipeng,Yi Zhengjin,Xiao Chuan,et al.Efficacy of transurethral submucosal dissection of bladder tumor combined with intraoperative bladder submucosal injection of gemcitabine in treatment of non-muscle invasive urothelial bladder cancer: a report of seven cases[J].Journal of Chongqing Medical University,2023,48(8):894-897. DOI： 10.13406/j.cnki.cyxb.003302.

摘要

目的

探讨经尿道膀胱肿瘤黏膜下剥离术联合术中膀胱黏膜下注射吉西他滨治疗膀胱非肌层浸润性尿路上皮癌（non-muscle invasive urothelial bladder cancer，NMIBC）的安全性及有效性。

方法

回顾性分析2021年6月至2022年9月攀钢集团总医院泌尿外科收治的7例单发NMIBC患者临床资料。利用专用膀胱黏膜注射针经膀胱镜于肿瘤基底部注射吉西他滨（20 mg/mL）形成局部水肿后行膀胱肿瘤内镜黏膜下剥离术（bladder tumor endoscopic mucosal dissection，BT-ESD）。记录手术时间、术后住院时间、术后病理结果、术后并发症发生情况，估算术中出血量，术后3个月及术后1年复查膀胱镜，统计复发率。

结果

7例患者顺利完成BT-ESD，无中转开放手术及改为其他手术方案。术后无非计划再次手术止血，未发生创面膀胱穿孔，术中无输血。其中男性5例，女性2例，肿瘤最大径0.7～2.0 cm，平均（0.9±0.4） cm，肿瘤均为菜花状，带蒂，位于膀胱侧壁2例，右侧输尿管脊2例，左侧输尿管脊2例，三角区1例。手术时间20～40 min，平均（31.40±2.67） min。术中出血量1～5 mL，平均（2.24±1.46） mL。术后住院时间1～2 d。手术后病理结果为低风险非肌层浸润性膀胱尿路上皮癌，手术切缘均为阴性。术后3个月及术后1年，复查膀胱镜，未见复发、进展。

结论

膀胱肿瘤内镜黏膜下剥离术中膀胱黏膜下注射吉西他滨治疗非肌层浸润性尿路上皮膀胱癌是安全、可靠、有效的。

Abstract

Objective

To investigate the safety and efficacy of transurethral submucosal dissection of bladder tumor combined with intraoperative bladder submucosal injection of gemcitabine in the treatment of non-muscle invasive urothelial bladder cancer（NMIBC）.

Methods

A retrospective analysis was performed for the clinical data of seven patients with solitary NMIBC who were admitted to our department from June 2021 to September 2022. Bladder tumor-endoscopic submucosal dissection（BT-ESD） was performed after the formation of local edema by injection of gemcitabine（20 mg/mL） at the base of the tumor via cystoscopy using a special bladder mucosal injection needle. Time of operation，length of postoperative hospital stay，postoperative pathological findings，and postoperative complications were recorded，and intraoperative blood loss was estimated. Cystoscopy was performed at 3 months and 1 year after surgery，and recurrence rate was calculated.

Results

All seven patients underwent successful BT-ESD，with no patients converted to open surgery or other surgical regimens. There was no unscheduled postoperative reoperation for hemostasis，traumatic bladder perforation or intraoperative blood transfusion. Of all seven patients，there were five male patients and two female patients，and the maximum tumor diameter ranged from 0.7 to 2.0 cm，with a mean diameter of （0.9±0.4） cm；all tumors were cauliflower-shaped and pedicled and were located in the lateral wall of the bladder in two patients，in the right ureteral ridge in two patients，in the left ureteral ridge in two patients，and in the trigone in one patient. The time of operation was 20-40 minutes，with a mean time of （31.40±2.67） minutes. The volume of intraoperative blood loss was 1-5 mL，with a mean volume of （2.24±1.46） mL. The length of postoperative hospital stay was 1-2 days. Postoperative pathological findings showed low-risk NMIBC with negative surgical margins. Cystoscopy was performed at 3 months and 1 year after surgery and showed no recurrence or progression.

Conclusion

The submucosal injection of gemcitabine into the bladder during BT-ESD is safe，reliable，and effective in the treatment of NMICB.

关键词

Keywords

references

Siegel RL ， Miller KD ， Jemal A . Cancer statistics，2020 [J ] . CA Cancer J Clin ， 2020 ， 70 （ 1 ）： 7 - 30 .

贺宇彤，李道娟，梁　迪，等 . 2014年中国膀胱癌发病和死亡分析 [J ] . 中华肿瘤杂志， 2018 ， 40 （ 9 ）： 647 - 652 .

He YT ， Li DJ ， Liang D ， et al . Incidence and mortality of bladder cancer in China，2014 [J ] . Chin J Oncol ， 2018 ， 40 （ 9 ）： 647 - 652 .

经尿道膀胱肿瘤等离子电切安全共识 [J ] . 现代泌尿外科杂志， 2018 ， 23 （ 12 ）： 895 - 901 .

Safety consensus of transurethral plasmakinetic resection of bladder tumor [J ] . J Mod Urol ， 2018 ， 23 （ 12 ）： 895 - 901 .

Babjuk M ， Böhle A ， Burger M ， et al . EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder：update 2016 [J ] . Eur Urol ， 2017 ， 71 （ 3 ）： 447 - 461 .

付晨辉 . 经尿道膀胱肿瘤整块切除术对标本病理诊断的影响 [D ] . 天津：天津医科大学， 2018 .

Fu CH . Effect of transurethral resection of bladder tumor on pathological diagnosis of specimens [D ] . Tianjin ： Tianjin Medical University ， 2018 .

Engilbertsson H ， Aaltonen KE ， Björnsson S ， et al . Transurethral bladder tumor resection can cause seeding of cancer cells into the bloodstream [J ] . J Urol ， 2015 ， 193 （ 1 ）： 53 - 57 .

杨　诚，梁朝朝 . 膀胱肿瘤整块切除术的应用现状与进展 [J ] . 临床泌尿外科杂志， 2018 ， 33 （ 3 ）： 245 - 248 .

Yang C ， Liang CZ . Application and progress of en-bloc resection of bladder tumor [J ] . J Clin Urol ， 2018 ， 33 （ 3 ）： 245 - 248 .

刘　晓，窦利州，薛丽燕，等 . 早期胃癌内镜黏膜下剥离术与外科手术临床效果及生存质量的回顾性对比研究 [J ] . 中华消化内镜杂志， 2017 ， 34 （ 8 ）： 6 .

Liu X ， Dou LZ ， Xue LY ， et al . Comparative analysis for clinical efficacy and life quality between endoscopic submucosal dissection and surgical treatment of patients with early gastric cancer [J ] . Chin J Dig Endosc ， 2017 ， 34 （ 8 ）： 6 .

徐向军，黄永斌，刘兆飞，等 . 医源性腔镜下输尿管损伤的原因分析与处理 [J ] . 中国微创外科杂志， 2019 ， 19 （ 4 ）： 372 - 374 .

Xu XJ ， Huang YB ， Liu ZF ， et al . Cause analysis and treatment of iatrogenic ureter injury under endoscope [J ] . Chin J Minim Invasive Surg ， 2019 ， 19 （ 4 ）： 372 - 374 .

朱　捷，徐阿祥，陈光富，等 . 应用海博刀经尿道膀胱肿瘤黏膜下切除术（附41例病例报道） [J ] . 现代泌尿生殖肿瘤杂志， 2019 ， 11 （ 4 ）： 200 - 204 .

Zhu J ， Xu AX ， Chen GF ， et al . Early experiences of bladder tumor endoscopic submucosal dissection using Hybrid Knife：report of 41 cases [J ] . J Contemp Urol Reproductive Oncol ， 2019 ， 11 （ 4 ）： 200 - 204 .

Yang DR ， Xue BX ， Zang YC ， et al . Efficacy and safety of potassium-titanyl-phosphate laser vaporization for clinically non-muscle invasive bladder cancer [J ] . Urol J ， 2014 ， 11 （ 1 ）： 1258 - 1263 .

谢甜甜，刘　涛，张昊 . 1 470 nm激光剜除术治疗非肌层浸润性膀胱肿瘤的临床疗效 [J ] . 中国医科大学学报， 2022 ， 51 （ 10 ）： 932 - 935 .

Xie TT ， Liu T ， Zhang H . Clinical efficacy of 1 470 nm laser enucleation in the treatment of non-muscular invasive bladder tumor [J ] . J China Med Univ ， 2022 ， 51 （ 10 ）： 932 - 935 .

亢　渐，张丽娜，牛吉瑞 . 比较1 470 nm激光切除术和经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的临床疗效 [J ] . 当代医学， 2022 ， 28 （ 18 ）： 143 - 145 .

Kang J ， Zhang LN ， Niu JR . To compare the clinical efficacy of 1 470 nm laser resection and transurethral resection of bladder tumor in the treatment of non-muscular invasive bladder cancer [J ] . Contemp Med ， 2022 ， 28 （ 18 ）： 143 - 145 .

Baumgarten AS ， Emtage JB ， Wilder RB ， et al . Intravesical lipiodol injection technique for image-guided radiation therapy for bladder cancer [J ] . Urology ， 2014 ， 83 （ 4 ）： 946 - 950 .

白　雪，马洪升，罗　利 . 中外日间手术发展对比研究及展望 [J ] . 中国医院管理， 2014 ， 34 （ 5 ）： 35 - 37 .

Bai X ， Ma HS ， Luo L . Research and prospect of comparison between China and abroad in the day surgery development [J ] . Chin Hosp Manag ， 2014 ， 34 （ 5 ）： 35 - 37 .

温海东，吕　军，王尉，等 . 经尿道绿激光汽化联合术中黏膜下多点注射吉西他滨治疗非肌层浸润性膀胱癌临床观察 [J ] . 国际外科学杂志， 2016 ， 43 （ 2 ）： 107 - 112 .

Wen HD ， Lü J ， Wang W ， et al . Clinical effect of PVBT combined with intraoperative submucosal multi-point injection of gemcitabine for treating NMIBC [J ] . Int J Surg ， 2016 ， 43 （ 2 ）： 107 - 112 .

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