浅表性膀胱癌等离子电切术后二次电切的临床疗效分析(附43例报告)

Clinical Effect of Repeat Resection after Transurethral Resection of Superficial Bladder Tumor with Plasmakinetic (PKRBT):A Report of 43 Cases

目的探讨浅表性膀胱癌等离子双极电切(PKRBT)术后常规二次电切预防肿瘤复发的临床疗效。方法 43例浅表性膀胱癌病人PKRBT术后4～6周常规行二次电切。首次PKRBT术后即行MMC40mg膀胱内灌注,常规MMC膀胱灌注12个月。对43例浅表性膀胱癌PKRBT术后常规二次电切的患者进行随访,总结二次电切对预防浅表性膀胱癌术后复发的临床效果。结果随访观察10～31个月,平均20.7个月,首次电切术后6个月复发1例(2.3%),12个月复发5例(11.6%),18个月复发8例(18.6%),24个月复发11例(25.6%)。其中,6例肿瘤无进展,5例肿瘤进展,9例再行PKRBT术,2例改行根治术。无瘤生存期平均为18.5个月,最长31个月。结论浅表性膀胱癌PKRBT术后常规行二次电切可有效减少肿瘤复发,延缓肿瘤进展,延长无瘤生存期,提高患者的生活质量。

Objective To assess the clinical effect of repeat resection after transurethral resection of superficial bladder tumor with bipolar plasmakinetic（PKRBT） on recurrence of bladder tumor. Methods A total of 43 cases of superficial bladder cancer underwent second resection in 4 ～ 6 weeks after PKRBT. All the cases were treated with intravesical instillation of 40 mg mitomycin C immediately after the first PKRBT. Regular intravesical instillation of mitomycin C had been given postoperatively to all the cases for one year. All cases were followed up for 10 to 31 months（the mean was 20.7 months） . The clinical data of the second transurethral resection in preventing recurrence of superficial bladder cancer were summed up. Results All cases were followed up for 10 ～ 31 months,with an average of 20.7 months. 1,5,8,11cases recurred at 6,12,18,24 months respectively. Among them,6 cases hadn＇t tumor progression,5 cases had tumor progression,9 cases underwent second PKRBT surgery,2 cases diverted to radical bladder cancer surgery. The time of recurrence-free survival was 18.5 months on average,up to 31 months. Conclusions Repeat resection after first PKRBT can effectively reduce tumor recurrence,delay tumor progression and prolong disease-free survival,improve the patients＇ quality of life.