经尿道整块剜除技术在非肌层浸润性膀胱癌手术治疗中的应用  

Application of transurethral transurethral enucleation technique in the surgical treatment of non-muscle invasive bladder cancer

作　　者：贾其磊[1] 张策伟 汪海波 唐鹏 JIA Qilei;ZHANG Cewei;WANG Haibo;TANG Peng(Department of Urology,Qingbaijiang District People's Hospital,Sichuan Province,Chengdu 610030,China)

机构地区：[1]成都市青白江区人民医院泌尿外科,四川成都610300

出　　处：《中国当代医药》2025年第9期63-67,72,共6页China Modern Medicine

基　　金：四川省成都市卫健委医学科研项目(2021423)。

摘　　要：目的探讨经尿道整块剜除技术在非肌层浸润性膀胱癌手术治疗中的应用效果。方法回顾性分析2018年1月至2023年12月成都市青白江区人民医院收治的106例非肌层浸润性膀胱癌患者的临床资料,按照手术操作方法分为对照组(47例)、研究一组(33例)和研究二组(26例)。对照组采用等离子常规电切方法,研究一组采用等离子整块剜除方法,研究二组采用钬激光整块剜除方法。比较三组患者手术时间、术中出血量、并发症、复发率。结果三组手术时间比较,差异有统计学意义(P<0.05);研究二组、研究一组的手术时间短于对照组,差异有统计学意义(P<0.05)。三组术中出血量比较,差异有统计学意义(P<0.05);研究二组术中出血量少于对照组、研究一组,差异有统计学意义(P<0.05)。三组并发症总发生率比较,差异无统计学意义(P>0.05)。三组肿瘤复发率比较,差异无统计学意义(P>0.05)。结论采用等离子电切环和低能量钬激光均可顺利完成整块剜除手术,简单易行,容易掌握,更容易获得完整的标本,有利于病理检查和分期,且并发症少,早期随访膀胱肿瘤复发率低,临床效果较好,侧壁肿瘤可减少闭孔反射的发生,采用激光剜除无闭孔反射的发生,勾取法取出标本不会造成尿道种植。Objective To investigate the effect of transurethral enucleation in the treatment of non-muscle invasive bladder cancer.Methods The clinical data of 106 patients with non-muscle invasive bladder cancer admitted to Qingbaijiang Dis-trict People's Hospital of Chengdu City from January 2018 to December 2023 were retrospectively analyzed,and they were divided into control group(47 cases),study group 1(33 cases)and study group 2(26 cases)according to surgical procedures.The control group was subjected to plasma routine electrotomy,the study group was subjected to plasma whole enucleation,and the study group was subjected to holmium laser whole enucleation.The operation time,intraoperative blood loss and complications of the three groups were compared.Results The operation time of the three groups was compared,the difference was statisti-cally significant(P<0.05).The operation time of study group 2 and study group 1 was shorter than that of control group,and the difference was statistically significant(P<0.05).The difference of intraoperative blood loss among the three groups was statistically significant(P<0.05).The amount of intraoperative blood loss in study group 2 was less than that in control group and study group 1,and the difference was statistically significant(P<0.05).There was no significant difference to the total incidence of complications of the three groups(P>0.05).There was no significant difference in the recurrence rate a-mong the three groups(P>0.05).Conclusion Both plasma electrotomy and low-energy holmium laser can successfully complete the whole enucleation operation,which is simple and easy to master,and easier to obtain complete specimens,which is beneficial to pathological examination and staging,with fewer complications,low recurrence rate of bladder tumor in early follow-up,and good clinical effect.Sidewall tumors can reduce the occurrence of obturator reflex,and laser enucle-ation without obturator reflex occurs.Extraction of specimens by hook method does not result in urethral implantation.

关 键 词：非肌层浸润性膀胱癌 经尿道膀胱肿瘤电切术 整块剜除 等离子 钬激光 

分 类 号：R737.14[医药卫生—肿瘤]