逆行黏膜下整块剜切术治疗非肌层浸润性膀胱癌的疗效分析(1)

http://www.100md.com 2019年10月1日 《新医学》 201910

     【摘要】 目的 評估经尿道等离子电切镜逆行黏膜下膀胱肿瘤整块剜切术(ERBT)治疗原发性非肌层浸润性膀胱癌(NMIBC)的安全性和有效性。方法 分别收集采用ERBT治疗的35例NMIBC患者(ERBT组)和采用常规经尿道膀胱肿瘤电切术(TURBT)治疗的40例NMIBC患者(TURBT组)的临床和手术资料，比较2组患者围手术期指标和并发症。结果 与TURBT组相比，ERBT组术中没有膀胱穿孔病例发生，6例出现闭孔神经反射;TURBT组19例患者出现闭孔神经反射，其中2例发生膀胱穿孔(Ⅰ级)。ERBT组术中闭孔神经反射发生率低于TURBT组，膀胱持续冲洗时间短于TURBT组(P均< 0.05)。2组患者手术时间、术后血红蛋白下降程度和导尿管留置时间、住院时间比较差异均无统计学意义(P均> 0.05)。随访期间2组患者的肿瘤复发率及无进展生存率相近(P均> 0.05)。结论 与TURBT相比，ERBT治疗NMIBC可减少术中闭孔神经反射发生率和缩短术后持续膀胱冲洗时间，且不增加近期肿瘤复发率。

    【关键词】 非肌层浸润性膀胱癌;经尿道膀胱肿瘤电切术;经尿道膀胱肿瘤整块剜切术

    Clinical efficacy of transurethral en-bloc resection of non-muscle invasive bladder cancer Wan Song， Zhou Yulin， Jiang Wencong， Li Tengcheng， Di Jinming. Department of Urology， Huadu District People’s Hospital， Guangzhou 510800， China

    Corresponding author， Li Tengcheng， E-mail： tengchengli@ 126. com

    【Abstract】 Objective To evaluate the safety and efficacy of transurethral en-bloc resection of bladder tumor (ERBT) in the treatment of primary non-muscle invasive bladder cancer (NMIBC). Methods Clinical and surgical data of 35 NMIBC patients undergoing ERBT (ERBT group) and 40 NMIBC cases treated with conventional transurethral resection of bladder tumor (TURBT group) were collected. The perioperative parameters and complications were statistically compared between two groups. Results Compared with the conventional TURBT group， no bladder perforation occurred and obturator nerve reflex was noted in 6 patients in the ERBT group. In the TURBT group， 19 patients developed obturator nerve reflex and 2 cases of them presented with bladder perforation (Clavien level I). Compared with TURBT group， ERBT group had lower incidence of obturator nerve reflex and shorter duration of continuous bladder irrgation (both P < 0.05). The operation time， postoperative hemoglobin decline， catheter retention time and length of hospital stay did not significantly differ between two groups (all P > 0.05). During postoperative follow-up， the tumor recurrence rate and progression-free survival rate did not remarkably differ between two groups (both P > 0.05). Conclusion Compared with traditional TURBT， ERBT can reduce the incidence of intraoperative obturator nerve reflex， shorten the time of postoperative bladder irrigation and does not increase the short-term tumor recurrence rate in NMIBC patients.

    【Key words】 Non-muscle invasive bladder cancer;Transurethral resection of bladder tumor;

    En-bloc resection of bladder tumor(万颂?周宇林?江文聪?李腾成?狄金明)

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