Objective To evaluate the safety and efficacy of green laser photosselective vaporization in treatment of superficial bladder tumor.Methods Clinical data of 100 patients with superficial bladder tumor receiving treatment in our hospital were analyzed retrospectively and divided into groups green laser ( GL group, n = 31 ) and plasma ( n = 69 ).Surgical time, postoperative time of urethral catheterization detaining, hospital stay, recurrence rate and complications were compared between 2 groups.Results Follow - up lasted 50 ～ 1 837 d in GL group and 58 ～ 5 149 d in plasma group.Recurrence rate of GL group did not reduce as compared with plasma group, the difference was not significant ( P ＞ 0.05 ).Postoperative time of urethral catheterization detaining and hospital stay were significantly shorter in GL group than in plasma group ( P ＜0.05 ).In GL group, 3 had cystospasm ( 9.7％ ), 3 urinary system infection ( 9.7％ ), 1 bronchiectasis and hemoptysis ( 3.2％ ), no obturator nerve reflex occurred.In plasma group, 8 cystospasm (11.6％ ), 5 secondary hemorrhage ( 7.2％ ), including 1 having e-mergency exploratory laparotomy due to bleeding, 3 infection ( 4.3％ ), 1 angina pectoris attacks ( 1.4％ ), post - anesthesia headache ( 1.4％ ), and 8 obturator nerve reflex ( 11.6％ ).Conclusion Green laser photoselective vaporization, safe and effective in treatment of superficial bladder tumor, smaller traumas, less blood loss, shorter time of urethral catheterization detaining , shorter hospital stay, faster recovery, does not produce electric field effect, thus to avoid the occurrence of obturator nerve reflex.%目的 探讨绿激光治疗浅表性膀胱肿瘤的有效性和安全性.方法 对我院100例浅表性膀胱肿瘤患者进行回顾性分析,其中绿激光组31例,等离子组69例,对两组手术时间、术后留置导尿管时间、术后住院时间、术后复发率、并发症等进行比较.结果 绿激光组术后随访50～1 837 d,等离子组术后随访58～5 149 d.绿激光组手术时间及术后复发率与等离子组比较,差异无统计学意义(P＞0.05);绿激光组术后留置导尿管时间及术后住院时间较等离子组均明显缩短,差异有统计学意义(P＜0.05).绿激光组术后发生膀胱痉挛3例(9.7%),泌尿系感染3例(9.7%),支气管扩张、咯血1例(3.2%).术中无一例发生闭孔神经反射.等离子组术后发生膀胱痉挛8例(11.6%),继发性出血5例(7.2%),其中1例术后由于出血明显急诊行剖腹探查术,感染3例(4.3%,其中泌尿系感染2例,肺部感染1例),心绞痛发作1例(1.4%),麻醉后头痛1例(1.4%).术中发生闭孔神经反射8例(11.6%).结论 绿激光治疗浅表性膀胱肿瘤是安全、有效的,具有创伤小、出血少、留置导尿管时间短、术后住院时间短、恢复快等优势,在手术局部不产生电场效应,从而避免了闭孔神经反射的发生.
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