1470nm激光经尿道膀胱肿瘤整块切除疗效观察  

Effect analysis of 1470nm laser en bloc transurethral resection of bladder tumor in the treatment of nonmuscle invasive bladder tumor

作　　者：李功成[1] 潘铁军[1] 文瀚东[1] 沈国球[1] 

机构地区：[1]广州军区武汉总医院泌尿外科,武汉430070

出　　处：《临床泌尿外科杂志》2017年第4期264-266,共3页Journal of Clinical Urology

摘　　要：比较1 470nm激光经尿道膀胱肿瘤整块切除(EBRBT)与经尿道膀胱肿瘤切除术(TURBT)治疗非肌层浸润性膀胱癌(NMIBC)的有效性和安全性。方法:回顾性分析2014年1月~2016年3月我院NMIBC患者的临床资料,其中行1 470nm激光EBRBT的患者35例(EBRBT组),行TURBT的患者42例(TURBT组),分析两组患者术前、术中、术后临床及随访资料。结果:两组手术均成功。两组手术时间、6个月的短期复发率相比较差异无统计学意义(P>0.05)。EBRBT组与TURBT组术后膀胱冲洗时间[(0.94±1.23)d vs.(1.92±1.31)d],术后留置尿管时间[(4.30±1.89)d vs.(6.38±1.34)d],术后住院时间[(5.37±1.25)d vs.(6.56±1.04)d],1年复发率[(5.7%vs.23.8%]相比较,EBRBT组优于TURBT组,差异有统计学意义(P<0.05)。EBRBT无闭孔神经反射以及膀胱穿孔发生,在TURBT组发生闭孔神经反射8例,膀胱穿孔5例。结论:1 470nm激光经尿道膀胱肿瘤整块切除可以有效地进行临床应用。Objective：To compare the efficacy and safety between conventional and 1 470 nm laseren bloctransurethral resection of bladder tumor（EBRBT and TURBT）in the treatment of nonmuscle invasive bladder cancer（NMIBC）.Method：From January 2014 to March 2016,77 patients with NMIBC underwent endoscopic surgery.Among them,42 patients underwent TURBT and 35 patients underwent 1 470 nm laser.Clinical data including preoperative,operative,and postoperative management and follow-up were recorded.Result：All cases were completed successfully.There was no significant difference in operative duration between the groups（P〉0.05）.The EBRBT group was superior to the TURBT group in terms of postoperative bladder irrigation time [（0.94±1.23）d vs（1.92±1.31）d],urethral catheterization [（4.30±1.89）d vs（6.38±1.34）d],hospitalization[（5.37±1.25）vs（6.56±1.04）d],and one-year recurrence after operation（5.7%vs 23.8%）.Obturator nerve reflex and bladder perforation occurred only in the TURBT group,eight cases of obturator nerve reflex and five cases of bladder perforation.Conclusion：The en bloc transurethral resection with 1 470 nm laser is safe and effective for patients with NMIBC.

关 键 词：膀胱肿瘤 经尿道膀胱肿瘤切除术 1470nm激光 

分 类 号：R737.14[医药卫生—肿瘤]