经尿道膀胱肿瘤电切变性术治疗膀胱肿瘤疗效10年回顾  

Transurethral resection and degeneration of bladder tumor to treat bladder cancer:A 10-year review

作　　者：方炜[1] 李威武[1] 左晓明[1] 陆鸿海[1] 刘思宽[1] 王晖[1] 张炳辉[1] 李爱华[1] FANG Wei LI Wei-wu ZUO Xiao-ming LU Hong-hai LIU Si-kuan WANG Hui ZHANG Bing-hui LI Ai-hua(Department of Urology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, Chin)

机构地区：[1]同济大学附属杨浦医院泌尿外科,上海200090

出　　处：《现代泌尿外科杂志》2017年第8期593-597,共5页Journal of Modern Urology

摘　　要：目的回顾性评估经尿道膀胱肿瘤电切变性术(TURD-Bt)治疗膀胱肿瘤的长期疗效。方法 2005年9月至2016年5月采用TURD-Bt治疗86例非肌层浸润性膀胱癌(NMIBC)和46例T2期肌层浸润性膀胱癌(MIBC),回顾性观察其疗效。并进一步与46例经尿道膀胱肿瘤电切术(TURBt)比较,评估TURD-Bt治疗NMIBC的疗效。结果平均随访时间(44.27±31.89)月。术后膀胱肿瘤复发NMIBC组5例(5.81%),MIBC组18例(39.13%,与NMIBC组比较,P<0.01),TURBt组22例(47.83%,与NMIBC组比较,P<0.01)。肿瘤转移NMIBC组4例(4.65%),MIBC组4例(8.70%),TURBt组10例(21.74%,与NMIBC组比较,P<0.01)。肿瘤死亡NMIBC组1例(1.16%),MIBC组6例(13.04%,与NMIBC组比较,P<0.05),TURBt组18例(39.13%,与NMIBC组比较P<0.01)。5年总生存率NMIBC组81.39%,MIBC组60.02%,TURBt组48.30%,与NMIBC组比较,P<0.0001,差异有显著统计学意义。结论采用TURD-Bt治疗NMIBC或MIBC,常规凝固变性肿瘤创面深部组织将有助于减少肿瘤复发。TURD-Bt和TURBt一样安全,可替代现行的TURBt治疗膀胱肿瘤。ObjectiveTo evaluate the long-term outcomes of transurethral resection and degeneration of bladder tumor（TURD-Bt） in the treatment of bladder tumor.MethodsThe clinical data of 86 cases of non-muscle invasive bladder cancer（NMIBC） and 46 cases of stage T2 muscle invasive bladder cancer（MIBC） treated with TURD-Bt during Sept.2005 and May 2016 were retrospectively reviewed.The surgical outcomes were further compared with 46 patients treated with transurethral resection of bladder tumor（TURBt）.ResultsDuring the follow-up of （44.27±31.89）months,bladder tumor recurred in 5 NMIBC cases（5.81%）,18 MIBC cases（39.13%,compared with NMIBC,P〈0.01） and 22 TURBt cases （47.83%,compared with NMIBC,P〈0.01）.Metastasis occurred in 4 NMIBC cases（4.65%）,4 MIBC cases （8.70%） and 10 TURBt cases （21.74%,compared with NMIBC, P〈0.01）.Death occurred in 1 NMIBC case（1.16%）,6 NMIBC case （13.04%,compared with NMIBC, P〈0.05） and 18 TURBt cases（39.13%,compared with NMIBC,P〈0.01）.The 5-year overall survival was 81.39% in NMIBC cases,60.02% for MIBC cases and 48.30%（compared with NMIBC,P〈0.000 1） for TURBt cases.ConclusionsIn the treatment of NMIBC and MIBC with TURD-Bt,the conventional coagulation degeneration to the deep tissues under tumor wound is helpful to reduce tumor recurrence.TURD-Bt is as safe as TURBt,and may replace conventional TURBt in the treatment of bladder tumor.

关 键 词：膀胱癌 肿瘤复发 凝固变性 经尿道膀胱肿瘤电切变性术 手术疗效 

分 类 号：R699.5[医药卫生—泌尿科学]