非肌层浸润性膀胱癌铥激光整块切除术后二次经尿道切除的临床疗效分析  

Clinical efficacy analysis of repeat transurethral resection after thulium laser en bloc resection for non-muscle invasive bladder cancer

作　　者：朱达伟 袁方 王呈 刘南 袁刚军 Zhu Dawei;Yuan Fang;Wang Cheng;Liu Nan;Yuan Gangjun(Department of Urological Oncology,Chongqing University Cancer Hospital,Chongqing 400030,China)

机构地区：[1]重庆大学附属肿瘤医院泌尿肿瘤科,重庆400030

出　　处：《微创泌尿外科杂志》2024年第6期383-387,共5页Journal of Minimally Invasive Urology

基　　金：重庆市科研机构绩效激励引导专项(cstc2022jxjl120029)。

摘　　要：目的:探讨应用经尿道铥激光膀胱肿瘤整块切除术(TmLERBT)后二次经尿道切除术治疗非肌层浸润性膀胱癌(NMIBC)的疗效。方法:回顾性分析2020年8月至2023年4月在重庆大学附属肿瘤医院行TmLERBT治疗的98例NMIBC患者的临床和病理资料,根据患者是否行二次经尿道切除手术分为A组(43例)和B组(55例)。A组患者TmLERBT术后行二次经尿道切除术,B组未行二次经尿道切除。比较两组患者复发进展的情况,分析TmLERBT治疗后再行二次经尿道切除术对NMIBC患者疾病控制的临床意义。结果:术后A组平均随访(27.53±10.57)个月,B组平均随访(24.47±11.73)个月,两组随访时间比较差异无统计学意义(P=0.184)。随访期间,A组复发率为16.3%(7/43),进展率为4.7%(2/43);B组复发率为21.8%(12/55)例,进展率为7.3%(4/55);两组复发率及进展率比较差异均无统计学意义(P值分别为0.491和0.910)。结论:短期随访结果提示NMIBC患者经TmLERBT治疗后行二次经尿道切除术并不能降低肿瘤复发和进展的风险,TmLERBT技术可能是避免二次经尿道切除术的有效方法。Objective:To investigate the efficacy of secondary transurethral resection in the treatment of nonmuscle invasive bladder cancer(NMIBC)after transurethral thulium laser en bloc resection of bladder tumors(Tm⁃LERBT).Methods:A retrospective analysis was conducted on the clinical and pathological data of 98 NMIBC pa⁃tients who underwent TmLERBT at Chongqing University Cancer Hospital from August 2020 to April 2023.Based on whether the patients underwent secondary transurethral resection,they were divided into Group A(43 cases)and Group B(55 cases).Patients in Group A received secondary transurethral resection after TmLERBT,while those in Group B did not.The recurrence and progression rates between the two groups were compared,and the clinical signif⁃icance of secondary transurethral resection after TmLERBT for disease control in NMIBC patients was analyzed.Re⁃sults:The average follow-up period was(27.53±10.57)months for Group A and(24.47±11.73)months for Group B.There was no significant difference in the follow-up duration between the two groups(P=0.184).During the follow-up period,the recurrence rate in Group A was 16.3%(7/43),and the progression rate was 4.7%(2/43).In Group B,the recurrence rate was 21.8%(12/55),and the progression rate was 7.3%(4/55).There were no sta⁃tistically significant differences in recurrence and progression rates between the two groups(P=0.491 and P=0.910,respectively).Conclusion:Short-term follow-up results suggest that secondary transurethral resection after TmLERBT does not reduce the risk of tumor recurrence or progression in NMIBC patients.The TmLERBT technique may be an effective method to avoid the secondary transurethral resection.

关 键 词：膀胱癌 整块切除 铥激光 二次经尿道切除 

分 类 号：R737.14[医药卫生—肿瘤]