根治性经尿道电切术与开放性膀胱部分切除术治疗侵犯肌层膀胱肿瘤疗效的对比研究

A Comparative Evaluation of The Efficacy of Radcal Transurethral Resection and Partial Cystectomy for Muscule-invasivve Bladder Tumor

目的：研究根治性经尿道电切术（根治性TURBT）治疗膀胱肿瘤的疗效。方法：对已侵犯肌层的膀胱肿瘤48例,分别采用根治性TURBT术25例,按照根治性TURBT手术原则,切除肿瘤至膀胱外脂肪层,获得随访23例,随访时间24～60个月,采用膀胱部分切除术23例,获得随访21例,随访时间24～60个月。两组病例术后常规用吡柔比星进行膀胱灌注化疗。结果：根治性TURBT复发率30.5%（7/23）,膀胱部分切除复发率29.1%（6/21）,两组对比,肿瘤复发率无显著差异（P〉0.05）。结论：对已侵犯肌层的膀胱肿瘤,根治性TURBT可作为泌尿外科医生选择的一种手术方法,特别适用于高危患者或不愿意接受开放手术的患者。

Objective： To evaluate the efficacy of radical transurethral resection for museul- invasive bladder tumor （ radical TURBT ） . Methods： 48 patients with muscul- invasive bladder cancer weve entered into the study of them 25 patients underwent radical TURBT . The procedure was based upon the principle of radical TURBT , with the muscle- invasive bladder cancers being transurethral resection to fatty lager outsidethe bladder wall . 23 cases were followed - up for 24 to 60 months . The remaining 23 patients underwent partial cystectomy . 21 cases were folloned - up for 3 to 60 months . After operation bladder instillation with THP given in both groups . Results： For radical TURBT group the recurrence rate was 30.4 % （ 7/23 ） and for partial systectomy group the recurrence fete was 29. 1% （ 6/21 ） . There was nosignificant difference between redical TURBT group and partial systectomy group （P 〉0.05 ） . Conclusions： Radical TURBT can be selected surgical treatment for muscle - invasire bladder cancer cases , especially for those who are alder and weak , and those who refuse the open surgery.