摘要
目的观察经尿道铥激光膀胱肿瘤完整切除术与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的疗效以及安全性。方法选取2013年12月至2016年1月在我院行膀胱肿瘤手术患者120例,其中经尿道铥激光膀胱肿瘤完整切除术组(Tm-Yag laser组)患者60例,TURBT患者60例(TURBT组),分别比较两组患者的手术时间、术中的出血量、术后持续膀胱冲洗液颜色变清亮时间、术后留置尿管时间、术后住院时间,及出现膀胱刺激症状、闭孔神经反射、膀胱穿孔的发生率,6个月及1年的复发率。结果 2组手术时间、出现膀胱刺激症状的发生率、6个月的短期复发率相比较无统计学意义(P>0.05)。而在术中出血量[(2.25±1.95)mL vs.(8.21±6.81)mL,P=0.001)、术后持续膀胱冲洗液颜色变清亮时间[(7.58±9.83)h vs.(34.67±18.20)h,P=0.001]、术后留置尿管时间[(3.31±1.33)d vs.(4.64±1.15)d,P=0.044]、术后住院时间[(4.31±1.32)d vs.(5.67±1.54)d,P=0.034]、1年复发率方面Tm-Yag laser组(1.67%vs.13.33%,P=0.032)显著优于TURBT组,差异具有统计学意义(P<0.05)。闭孔神经反射以及膀胱穿孔都发生在TURBT组。结论经尿道铥激光膀胱肿瘤完整切除术术可以避免膀胱穿孔等并发症的发生率降低远期复发率,安全,可以使患者获益,值得临床推广应用。
Objective To compare the clinical efficacy and safety of en bloc transurethral resection with thulium-yag laser （Tm-Yag laser） and transurethral resection of bladder tumor （TURBT） in the treatment of non-muscle invasive bladder cancer （NMBIC）. Methods A total of 120 non-muscle invasive bladder cancer（NMBIC） cases treated during Dec. 2013 and Jan. 2016 were enrolled, including 60 cases which underwent TURBT （TURBT group） and 60 cases which underwent en bloc tran- surethral resection with Tm-Yag laser （Tm-Yag laser group）. The operation time, intraoperative blood loss, days for urethral catheterization, hospitalization after surgery, bladder irritation symptoms, occurrence of obturator nerve reflex, bladder per- foration and recurrence 6 months and 1 year after treatment were compared between the two groups. Results There were no significant differences in the operation time, bladder irritation symptoms, and recurrence 6 months after operation （all P〉 0.05）. The Tm-Yag laser group was superior to the TURBT group in terms of intraoperative blood loss [（2.25 ± 1.95）mL vs. （8.21±6.81）mL,P=0. 001], postoperative bladder irrigation time [（7.58±9.83）h vs. （34.67± 18.20）h, P= 0. 001], ure thral catheterization [（3.31±1.33）d vs. （4.64± 1.15）d, P=0. 044], hospitalization [（4.31±1.32）d vs. （5.67± 1.54）d, P= 0. 034], and recurrence 1 year after operation （1.67% vs. 13.33%, P=0. 032）. Obturator nerve reflex and bladder perfora- tion occurred only in the TURBT group. Gonclusion The en bloc transurethral resection with Tm-Yag laser can avoid blad- der perforation and lower long-term recurrence rate. It is worth clinical promotion.
出处
《现代泌尿外科杂志》
CAS
2016年第9期670-672,686,共4页
Journal of Modern Urology
