经尿道内镜黏膜下剥离术治疗非肌层浸润性膀胱肿瘤150例疗效分析：单中心回顾性研究  

A single center retrospective clinical analysis of 150 cases with non-muscle invasive bladder tumor treated by bladder tumor endoscopic submucosal dissection(BT-ESD)

作　　者：程永毅[1] 孙羿[1] 李晶[1] 梁亮[1] 邓骞 段万里[1] 邹铁军[1] 屈卫星[1] 姜亚卓[1] 任伟[1] 杜春[1] 杜双宽[1] 赵文彩[1] CHENG Yongyi;SUN Yi;LI Jin;LIANG Liang;DENG Qian;DUAN Wanli;ZOU Tiejun;QU Weixing;JIANG Yazuo;REN Wei;DU Chun;DU Shuangkuan;ZHAO Wencai(Department of Urology, Shaanxi Provincial People’s Hospital, Xi’an 710061, China)

机构地区：[1]陕西省人民医院泌尿外科

出　　处：《现代泌尿生殖肿瘤杂志》2019年第4期196-199,204,共5页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：陕西省重点研发计划（2017SF-152）;重点项目-社会发展领域（2017ZDXM-SF-050）

摘　　要：目的探讨经尿道内镜黏膜下剥离术(BT-ESD)治疗非肌层浸润性膀胱癌(NMIBC)的有效性和安全性,以及影响BT-ESD疗效的因素。方法收集我院2013年11月至2019年6月行BT-ESD治疗的膀胱肿瘤患者150例,通过分析患者一般状况、肿瘤特征、术中状况、术后随访和复发情况等指标,利用卡方检验及t检验方法分析BT-ESD的疗效和安全性,并找出影响BT-ESD疗效的因素。结果截止2019年6月我院共完成BT-ESD手术161例,将术后病理证实为Ta/T1的150例患者纳入研究,其中男112例,女38例。切缘阴性切除率为99.3%(149/150),术中膀胱穿孔1例,术后出血3例,无手术死亡病例。单因素分析结果显示,肿瘤直径(P=0.032)及肿瘤病理分级(P=0.025)与肿瘤复发密切相关。截止2019年6月,BT-ESD术后累计无复发生存率为71.89%(最长随访时间63.08个月,平均随访时间34.63个月),其中随访满1、2、3、4和5年患者的无复发生存率为91.73%(122/133例)、88.18%(97/110例)、79.35%(73/92例)、67.50%(27/40例)和72.40%(12/17例)。结论本单中心回顾性研究证实BT-ESD治疗NMIBC安全、有效,可显著降低患者术后复发率。Objective To analyse the efficacy and safety of en bloc bladder tumor endoscopic sub-mucosal dissection (BT-ESD) in non-muscle invasive bladder cancer (NMIBC) patients by the single center retrospective observation. Methods A retrospective observation was carried out in Shaanxi Provincial People’s Hospital. From Nov.2013 to Jun.2019, 161 cases of BT-ESD were performed, 150 of which were eligible NMIBC (T a/T 1) patients. The operation time, blood loss, postoperative bladder irrigation time, catheter indwelling time, hospital stay and complications were observed and analyzed. All patients were under postoperative observation. Results Jun.2019, 161 cases of BT-ESD were performed, 150 of which were eligible NMIBC (T a/T 1). One case of bladder perforation and 3 cases of post-operative hemorrhage were observed, the R0 dissection rate was 99.3%(149/150). The univariate analysis showed the tumor relapse was related to tumor grade ( P =0.025) and tumor size ( P =0.032). The 1-year, 2-year, 3-year, 4-year and 5-year recurrent free survival rate were 91.73%, 88.18%, 79.35%, 67.50% and 72.40% respectively. The accumulated recurrent free survival rate was 71.89%(T max : 63.08 months, T medium : 34.63 months). Conclusions The single center observation showed the BT-ESD lead to a safe and effective approach for NMIBC treatment, which decreased the recurrent rate.

关 键 词：经尿道内镜黏膜下剥离术 非肌层浸润性膀胱肿瘤 单中心回顾性研究 

分 类 号：R737.14[医药卫生—肿瘤]