经尿道钬激光整块切除术治疗非肌层浸润性膀胱癌的疗效分析  

Analysis of the effect of transurethral holmium laser en-bloc resection for non-muscular invasive bladder cancer

作　　者：王振誉[1] 朱华[1] 张冰[1] 顾栋华[1] 郑兵[1] WANG Zhenyu;ZHU Hua;ZHANG Bing;GU Donghua;ZHENG Bing(Department of Urology,Nantong First People's Hospital,Nantong,Jiangsu,226000,China)

机构地区：[1]南通市第一人民医院泌尿外科,江苏南通226000

出　　处：《临床泌尿外科杂志》2021年第10期789-791,795,共4页Journal of Clinical Urology

基　　金：南通市卫健委青年科研基金(No:QA2019012);南通市科技项目(No:MS12020025)。

摘　　要：目的:比较经尿道膀胱肿瘤钬激光整块切除术(HOL-ERBT)与传统经尿道膀胱肿瘤电切术(TURBT)治疗非肌层浸润性膀胱癌(NMIBC)的疗效及安全性。方法:回顾性分析接受HOL-ERBT的85例NMIBC患者和同期接受TURBT的62例NMIBC患者的临床资料。比较两组手术时间、病理肌层检出率、手术并发症、肿瘤复发率等指标。结果:两组患者性别、年龄、肿瘤大小、肿瘤多发性和肿瘤分级比较差异无统计学意义。HOL-ERBT组和TURBT组患者的手术时间分别为(48.92±5.89)min和(51.00±7.17)min,膀胱穿孔率分别为8.24%和8.06%,创缘外复发率分别为3.53%和3.22%,肿瘤进展率分别为5.88%和3.23%,差异均无统计学意义(P>0.05)。两组病理肌层检出率分别为89.41%和54.84%,闭孔反射率分别为0和11.29%,原位复发率分别为23.53%和38.71%,差异均有统计学意义(P<0.05)。结论:HOL-ERBT应用于NMIBC的治疗显示出切除组织相对完整、围术期并发症少、疗效确切的优点,可作为TURBT治疗NMIBC的有效补充,值得进一步研究并推广。Objective:To compare the efficacy and safety of transurethral holmium laser en-bloc resection of bladder tumor(HOL-ERBT)and traditional transurethral resection of bladder tumor(TURBT)in the treatment of non-muscular invasive bladder cancer(NMIBC).Methods:The clinical data of 85NMIBC patients who received HOL-ERBT and 62 NMIBC patients who received TURBT were analyzed retrospectively.The operation time,pathological muscle detection rate,surgical complications,tumor recurrence rate and other indicators were com-pared between the two groups.Results:There was no statistical difference in gender,age,tumor size,tumor mul-tiplicity or tumor grade between the two groups.The operation time of patients in the HOL-ERBT group and TURBT group were(48.92±5.89)min and(51.00±7.17)min,respectively.The bladder perforation rate were 8.24%and 8.06%,and the recurrence rate outside the wound margin were 3.53%and 3.22%,respectively.The progress rates were 5.88%and 3.23%respectively,and the difference was not statistically significant(P>0.05).The detection rates of pathological myometrium were 89.41%and 54.84%,the obturator reflex rates were 0.00%and 11.29%,and the in situ recurrence rates were 23.53%and 38.71%,respectively.The difference was statistically significant(P<0.05).Conclusion:HOL-ERBT has the advantages of high safety,fewer complica-tions,and definite curative effect in the treatment of NMIBC.It has high application value in the clinical treatment of NMIBC,so it can be used as a feasible method for the treatment of NMIBC and be promoted.

关 键 词：非肌层浸润性膀胱癌 膀胱肿瘤电切 钬激光 整块切除 

分 类 号：R737.14[医药卫生—肿瘤]