经尿道膀胱肿瘤针状电极剜除治疗近输尿管口的膀胱肿瘤  

Analysis of en-bloc transurethral resection with needle-shaped electrode for treatment of bladder tumor around ureteral orifice

作　　者：郭涛[1,2] 符浩 谢小乓[1] 段斌[1] 唐昕[1] 唐亚纯 祖雄兵[2] Guo Tao;Fu Hao;Xie Xiaopang;Duan Bin;Tang Xin;Tang Yachun;Zu Xiongbing(Department of Urology,Affiliated Nanhua Hospital,University of South China,Hengyang 421002,China;Department of Urology,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]南华大学附属南华医院泌尿外科,湖南衡阳421002 [2]中南大学湘雅医院泌尿外科,长沙410008

出　　处：《中华腔镜泌尿外科杂志（电子版）》2021年第6期471-474,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：湖南省科技计划项目(2018SK51714);南华大学校级课题(南华科发[2019]02)。

摘　　要：目的探讨经尿道膀胱肿瘤针状电极剜除(TUNER-BT)治疗近输尿管口膀胱肿瘤的安全性及有效性。方法回顾性分析南华医院行手术治疗的68例近输尿管口膀胱肿瘤的患者临床资料,其中42例患者接受经尿道膀胱肿瘤电切术(TURBT),26例行TUNER-BT,对两组患者的基线特征、围术期临床资料进行对比分析。结果68例患者均顺利完成手术,两组患者的基线资料差异无统计学意义。相较于TURBT,TUNER-BT可以显著缩短肿瘤剜除时间[(11.46±3.92)min vs(14.86±3.25)min,P=0.001]、降低双J管留置率(3.8%vs 26.2%,P=0.019)及闭孔神经反射发生率(3.8%vs 21.4%,P=0.047)。此外,TUNER-BT可以降低术中膀胱穿孔(0%vs 4.8%)及术后肾积水发生率(3.8%vs 16.7%),但差异无统计学意义(P>0.05)。结论近输尿管口膀胱肿瘤针状电极剜除是安全可行的。相较传统TURBT,其可以提高效率,减少并发症,加快术后康复。Objective To explore the safety and efficacy of en bloc transurethral resection with needle-shaped electrode for treatment of bladder tumor around ureteral orifice.Methods The clinical data of 68 patients with bladder tumor around ureteral orifice were retrospectively compared,including 42 cases received transurethral resection of bladder tumor(TURBT),26 cases underwent transurethral needle-shaped electrode resection of bladder tumor(TUNER-BT).Results All operations were successful and the baseline characteristic of patients between TURBT and TUNER-BT were similar.As comparing with TURBT,TUNER-BT can significantly shorten tumor enucleation time[(11.46±3.92)min vs(14.86±3.25)min,P=0.001],reduce the rate of the double J tube indwelling(3.8%vs 26.2%,P=0.019)and perforated nerve reflex(3.8%vs 21.4%,P=0.047).Moreover,TUNER-BT can reduce the rate of intraoperative bladder perforation(0%vs 4.8%)and postoperative hydronephrosis(3.8%vs 16.7%),but the difference was not significant(P>0.05).Conclusion En-bloc transurethral resection with needle-shaped electrode for treatment of bladder tumor around ureteral orifice is safe,feasible and effecient.It can reduce the complications,and enhance recovery after operation.

关 键 词：膀胱肿瘤 针状电极 整块剜除 

分 类 号：R737.14[医药卫生—肿瘤]