临床评估同时切除前列腺和膀胱肿瘤对膀胱肿瘤复发的影响(附47例报告)

Clinical effect of simultaneous transurethral resection of bladder tumor and benign prostatic hyperplasia on recurrences of bladder tumor

目的:评估同时切除前列腺和膀胱肿瘤对膀胱肿瘤在膀胱颈部和(或)前列腺窝处复发的影响。方法:回顾性研究47例同时行经尿道膀胱肿瘤电切术和经尿道前列腺切除术的患者,分为膀胱肿瘤单发组26例和多发组21例,记录随访时间、肿瘤的复发时间、复发位置、复发数量以及肿瘤的进展,综合评价同时切除前列腺及膀胱肿瘤和膀胱肿瘤复发的关系。结果:所有患者随访1～4年,平均随访2.9年;膀胱肿瘤的平均复发率为68.1%,单发组复发率为53.8%,多发组复发率为85.7%,两组复发率差异有统计学意义(P<0.05);肿瘤平均复发时间15.1个月,单发组复发时间17.5个月,多发组复发时间12.4个月;在膀胱颈和(或)前列腺窝肿瘤复发10例(21.3%);在前列腺窝膀胱肿瘤平均复发时间为21.3个月,在单发组为26.0个月,而在多发组为20.6个月。3例患者(6.3%)最后发展为浸润性膀胱癌而行膀胱全切术。结论:同时切除前列腺和膀胱肿瘤是一种比较安全的手术策略,对膀胱肿瘤在膀胱颈和前列腺窝处的复发没有影响。

Objective： To evaluate the effect of simultaneous transurethral resection ot bladder tumor （TURBT） and benign prostatic byperplasia （TURP） on recurrences at the bladder neck and prostatic urethra. Methods：Data of 47 patients underwent simultaneous TURBT and TURP were reviewed（26 with single tumor and 21 with multiple tumor）. The follow up time, recurrence time, the local, the number of tumor and the tumor pro gression were recorded retrospectively. The relationship of the recurrences of bladder tumor and simultaneous transurethral resection of bladder tumor （TURBT） and benign prostatic hyperplasia （TURP） were analyzed sys tematically. Results：During the 1 to,l years of followup（mean 2. 9） the average tumor recurrence rate was 68.1%, 53.8% in single tumor group and 85.7% in mutiple tumor group（P〈0.05）. Recurrences appeared within an average of 15. 1 months, 17.5 months in single tumor group and 12.4 months in multiple tumor group. Tumor recur rence was at the bladder neck and/or prostatic urethra in 10 of the 47 cases （21.3%）. Average time to recurrence at the prostatic fossa was 21. 3 months, 26 in single tumor group and 20. 6 months in multiple tumor group. Tumor progressed to invaslveness was diagnosed in 3 of the 47 patients （6.3%）. Conclusions：The present study indicates that simultaneous TURBT and TURP do not negatively affect tumor recurrence at the bladder neck and prostatic urethra, and it may be an effective strategy to deal with the hypertrophy of prostate accompanied with bladder tumor.