经尿道钬激光整块切除术对非肌层浸润性膀胱癌的疗效观察  

Efficacy of transurethral holmium laser en-bloc resection for non-muscular invasive bladder cancer

作　　者：王鹏[1] 冷国雄[1] 权良明 WANG Peng;LENG Guoxiong;QUAN Liangming(Department of Urology,Huangshan People's Hospital,Huangshan 245000,China)

机构地区：[1]黄山市人民医院泌尿外科,安徽黄山245000

出　　处：《微创泌尿外科杂志》2020年第6期406-410,共5页Journal of Minimally Invasive Urology

摘　　要：目的:探讨经尿道钬激光膀胱肿瘤整块切除术(HoLERBT)与经尿道膀胱肿瘤等离子电切术(TUPKBT)对非肌层浸润性膀胱癌(NMIBC)的疗效差异.方法:选取102例NMIBC患者,根据手术方法进行分组,其中52例行HoLERBT术的患者为HoLERBT组,50例行TUPKBT术的患者为TUPKBT组,对比两组的手术时长、血红蛋白下降量、切除病灶含肌层率、术后并发症情况及2年复发率.观察两组手术前后血清CYFRA21-1及尿NMP-22水平差异.结果:与TUPKBT组比较,HoLERBT组手术时长、尿管留置时间、住院时间均明显缩短(P<0.05);HoLERBT组闭孔神经反射、并发症发生率以及复发率也明显降低(P<0.05).经病理检测,HoLERBT组切除组织的含肌层率明显高于TUPKBT组(P<0.05).术后3个月,两组血清CYFRA21-1及尿NMP-22水平均显著降低,其中HoLERBT组血清CYFRA21-1及尿NMP-22水平较TUPKBT组更低(P<0.05).结论:HoLERBT治疗NMIBC的效果显著,术后恢复快,可有效降低肿瘤标志物水平,减少并发症发生率及复发率.Objective:To investigate the differences in curative effect between transurethral en-bloc resection of bladder tumor(HoLERBT)and transurethral plasmakinetic resection of bladder tumor(TUPKBT)for non-muscular invasive bladder cancer(NMIBC).Methods:102 patients with NMIBC were selected for surgical treatment.According to the surgical methods,52 patients who were treated with HoLERBT served as HoLERBT group and 50 patients who were treated with TUPKBT served as TUPKBT group.The length of operation,reduction of hemoglobin,rate of muscle layer in excised lesions,postoperative complications and 2-year recurrence rate between two groups were compared.The serum levels of Cyfra21-1 and urine NMP-22 were observed before and after operation.Results:Compared with TUPKBT group,the operation duration,urinary catheter indwelling time and hospital stay in HoLERBT group were significantly shortened(P<0.05).The obturator nerve reflex,complication rate and recurrence rate were also significantly reduced in HoLERBT group(P<0.05).By pathological examination,the rate of muscle layer in resected tissue of HoLERBT group was significantly higher than in TUPKBT group(P<0.05).Three months after the operation,the levels of serum Cyfra21-1 and urine NMP-22 in two groups were significantly reduced,and those in the HoLERBT group were significantly lower than in TUPKBT group(P<0.05).Conclusion:The effect of HoLERBT on NMIBC is significant,the postoperative recovery is fast,the tumor marker level can be effectively reduced,and the complication and recurrence rate can be reduced.

关 键 词：经尿道 整块切除术 非肌层浸润性膀胱癌 疗效 肿瘤标志物 

分 类 号：R737.14[医药卫生—肿瘤]