2μm铥激光器治疗原发性非肌层浸润性膀胱癌的临床应用  

Clinical application of 2 μm thulium laser in the treatment of primary non - muscle invasive bladder cancer

作　　者：农毅 李碧君 孟小鑫[2] 林伟明 王在盛 李瑞宝 陈奇彪 

机构地区：[1]广东省湛江市第二人民医院泌尿外科,广东湛江524000 [2]江苏省人民医院泌尿外科,江苏南京210029

出　　处：《国际泌尿系统杂志》2017年第6期846-850,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨第三代2μm铥激光器治疗原发性非肌层浸润性膀胱癌（ non - muscleinvasive bladder cancer, NMIBC）的可行性和有效性。方法收集本院2011年1月至2016年6月间就诊的444例NMIBC患者的临床资料，对其中的151例进行前瞻性分析，研究该方法的有效性。结果共计292例患者纳入本研究，其中143例接受经尿道切除膀胱肿瘤（ transurethralresection of bladder tumor, TURBT）治疗，149例接受经尿道膀胱肿瘤激光汽化切除术（laser vapor-ization resection of bladder tumor, LvRBT）治疗。随访36个月，TURBT组和LVRBT组分别有61例（43％）和68例（46％）复发（P=0．610）。19例（7％）出现肿瘤进展，其中LVRBT组11例（8％），TURBT组8例（5％，P=0．420）。无瘤生存期平均为25个月，其中TURBT组26个月，LVRBT组25个月（P=0．730）。在低、中、高危险人群总体复发率分别为15％、42％和63％。手术时间TURBT组（28min）相对LVRBT组（32min）显著降低（P=0．040）。结论使用第三代2μm铥激光器治疗原发性非肌层浸润性膀胱癌（NMIBC）可行有效。且具有安全、并发症少、损伤小、术后康复快等一系列优势。其精准化切除，规范性手术是值得广泛推广的治疗手段。Objective To evaluate the rapeutic efficacy of the third 2 μm thulium laser in the treatment of primary non- muscle invasive bladder cancer（ NMIBC ）. Methods Clinical data of 444 patients with NMIBC in our hospital between January 2011 and June 2016 were collected, data of 151 patients were prospectively analyzed. Results A total of 292 patients were included in our study,in- cluding 143 patients received transurethral resection of bladder tumor （TURBT） and 149 patients re- ceived laser vaporization resection of bladder tumor（LVRBT）. After 36 months follow - up, 129 cas -es （44%） had recurrence： 61 （43 % ）cases in the TURBT group and 68 （46%） cases in the LVR -BT group （P =0. 610）. Tumor progression was found in 19 patients （7%） ： 11 patients in the TUR - BT and 8 patients in the LVRBT group （ P = 0. 420）. Median tumor - free survival was 25 months （ 26 in the TURBT group vs. 25 in the LVRBT group, P =0. 730）. Overall recurrence rate was 15%, 42. 1% and 63% in the low, intermediate low, and intermediate high risk subgroups, respectively. Oper- ation time was significantly lower in the TURBT than in the LVRBT group. Conclusions The third 2 μm thulium laser in the treatment of primary NMIBC has the advantages of safety, fewer complications, less injury, faster postoperative recovery and so on. This treatment is worth widely application for the normative operation, precise excision.

关 键 词：膀胱肿瘤 激光 铥 

分 类 号：R737.14[医药卫生—肿瘤]