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Purpose through observation and analysis of submucosal injection of distilled water after holmium laser resection of superficial bladder tumor surgery intraoperative, and postoperative clinical data, to assess whether the improvement of this surgical approach has certain advantages as well as the effectiveness of security and feasible in the operation sex. Materials and Methods From November 2004 to November 2007, a group of 22 patients with superficial bladder cancer patients 17 male patients, 5 females. Aged 17 to 82 years (mean 66 years), 18 cases with a history of gross hematuria, no clinical symptoms found in 3 patients by physical examination, repeated urinary frequency 1 cases, the course of 1 week to 2 years. Bladder tumor diameter 0.3 to 2.0cm, single 12 cases, 10 cases of multiple (2 to 3), one case of recurrence for TURBt. <1cm a tumor from the distance of the ureteral orifice, a front wall, located in the Triangle District 7 and the side walls 16. Preoperative MRI or CT scan were not invaded myometrium (stages T_a to T_l). Line cystoscope biopsy all patients in the preoperative diagnosis of urothelial cell carcinoma (grading G_ Ⅰ ~ G_ Ⅱ grade), using a long needle through the cystoscope into the bladder surgery, the tumor at the base and at the edge of 2cm pierce mucosal injection of distilled water, so that the mucosa uplift. Saline as perfusate, holmium laser parameter selection for the pulse can be 1.0 ~ 1.5J, a frequency of 10 ~ 20Hz, Power 10 ~ 30W, away from the edge of the tumor at the base 2cm at the holmium laser week cut mucosa, deep mucosa, The push with bladder lens Ministry stripping incision of the mucosa of the tumor together with the mucosa and bladder muscularis separation remove the tumor after soaking in distilled water bladder 5 minutes. 22 cases were successfully completed surgery, no case of bladder perforation, less blood loss, postoperative nor a large number of hematuria. The operation time is 25 to 45 minutes. Retain catheterization during the four cases of bladder spasm symptoms after extubation. Nine cases extubation after urinating, but not require medication. Were followed up for 3 to 28 months, no case of local recurrence. There are two cases stripped surface bulge and no smooth mucosa attachment, imaging examination, tumor recurrence can not be ruled out. After the biopsy and surgery to rule out recurrence. Ectopic recurrence in 3 cases, respectively, at 4 months, 9 and 1-year recurrence rate 13.6%. Recurrent tumors did not progress to invasive bladder tumor. Conclusion bladder submucosal injection of distilled water after holmium laser mucosal stripping method for the treatment of superficial bladder tumor efficacy is reliable, and the method of the holmium laser resection of superficial bladder tumor shorten the learning curve, reduce surgical complications. Medical cost savings. Whether it can reduce the phased increase in the risk of tumor recurrence needs further study.
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