2μm激光膀胱肿瘤切除术与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱肿瘤的疗效比较  

Comparison of 2 um continuous-wave laser resection and transurethral resection of bladder tumor for nonmuscle-invasive bladder tumor

作　　者：王毓斌[1] 吕永安[1] 邵晋凯[1] 李晓东[1] 

机构地区：[1]山西省人民医院泌尿外科,太原030012

出　　处：《肿瘤研究与临床》2012年第5期321-323,共3页Cancer Research and Clinic

基　　金：基金项目：山西省人民医院青年科研基金（2010-049）

摘　　要：目的比较2um激光膀胱肿瘤切除术与经尿道膀胱肿瘤电切术（TURBT）治疗非肌层浸润性膀胱肿瘤的安全性与疗效，评价2um激光治疗非肌层浸润性膀胱肿瘤的临床应用价值。方法62例非肌层浸润性膀胱肿瘤患者按照随机数字表法分为两组，32例行2um激光膀胱肿瘤切除术（2um激光组），30例行TURBT（TURBT组），记录手术时间、出血情况、相关并发症、导尿管留置时间、膀胱持续冲洗时间、术后住院天数及术后复发情况等。术后定期行吡柔比星膀胱灌注化疗。结果两组手术均成功，所有患者均未输血，2um激光组手术时间（32．5±10．5）min，与TURBT组的（31．3±9．8）min比较差异无统计学意义（t=0．364，P=0．674）。2um激光组未出现闭孔神经反射，TURBT组为3例。2um激光组和TURBT组术后平均膀胱冲洗时间分别为（6．2±2．6）h和（23．8±6．5）h（t=8．294，P=0．006）；术后平均留置尿管时间分别为（4．2±1．5）d和（5．2±1．8）d（t=1．468，P=0．103）；术后平均住院时间分别为（5．3±1．5）d和（5．8±2．8）d（t=0．627，P=0．531）。术后随访6～18个月，2um激光组3例复发，复发率9．4％，TURBT组3例复发，复发率10．0％，两组复发率差异无统计学意义（X=0．481，P=0．562）。结论2um激光治疗非肌层浸滑性膀胱肿瘤疗效确切，与TURBT相似，且具有并发症少、恢复快等优点。Objective To compare the safety and efficacy between RevoLix 2um continuous-wave （CW） laser resection of bladder tumor and transurethral resection of bladder tumor （TURBT） in patients with non-muscle-invasive bladder tumor, and to evaluate clinical value of 2 um CW laser resection for nonmuscle-invasive bladder tumor. Methods 62 patients with non-muscle-invasive bladder tumor were divided into 2 groups including 2 um CW laser resection group （32 cases） and TURBT group （30 cases） according to the random number table. The intravesical instillation of pirarubicin was performed regularly. The operative time, drop in hemoglobin, indwelling catheterization time, and operative complications were analyzed. Results All cases were completed successfully. The mean operative times of 2 um CW laser resection group and TURBT group were 32.5±10.5 min and 31.3± 9.8 min, respectively, and no statistical difference could be found between both groups （t = 0.364, P = 0.674）. 3 cases were found to have obturator nerve reflex in TURBT group, but no obturator nerve reflex was found in 2 um CW laser resection group. Bladder irrigation time of 2 um laser resection group was statistically shorter than that of TURBT group [ （6.2±2.6）h vs （23.8±6.5）h, t = 8.294, P= 0.0061. There was also no significant difference in postoperative catheterization time between both groups [（4.2±1.5）d vs （5.2±1.8）d,t = 1.468,P= 0.103 ]. Postoperative hospitalization time of the two groups was not shown significant difference[（5.3±1.5） d vs（5.8±2.8） d, t= 0.627,P= 0.531]. All cases were followed up for 6-18 months, and there were no significant difference in the recurrence rate between both groups （X2= 0.481, P = 0.562）. Conclusion 2 um CW laser resection is a novel excellent treatment for non-muscle-invasive bladder tumor and has the similar effect as TURBT with the advantage of significantly less blood loss and rapid recovery after surgery.

关 键 词：膀胱肿瘤 激光 经尿道膀胱肿瘤电切术 

分 类 号：R737.14[医药卫生—肿瘤]