经尿道铥激光膀胱部分切除与电切治疗膀胱癌的疗效比较

A comparative study of partial cystectomy with Thulium laser with standard transurethral resection of bladder tumor

目的:探讨经尿道铥激光膀胱部分切除与电切治疗膀胱癌的安全性及疗效。方法:2009年11月～2012年6月治疗膀胱癌患者108例,其中铥激光组55例,电切组53例,比较术中术后情况、肿瘤复发率等。结果:铥激光组手术时间(21.8±13.0)min、血色素下降(0.69±0.38)g、无闭孔神经反射。电切组手术时间(17.6±11.5)min、血色素下降(1.17±0.57)g、闭孔神经反射10例、2例中转开放。两组随访2～24个月,分别复发6例和10例。结论:经尿道铥激光膀胱部分切除术可达到并切除深肌层,可更准确进行病理分期,同时具有手术出血少、无闭孔神经反射等优势。但对于特殊部位的膀胱肿瘤,经尿道铥激光手术不能替代电切手术。

Objective： To assess the safety and efficacy of partial cystectomy with Thulium laser comparing with standard transurethral resection of bladder tumor （TURBT）. Method：Between November 2009 to June 2012, 108 patients with bladder carcinoma were involved into our study, 55 and 53 cases were in the Thulium laser group and TURBT group respectively. Preoperative and postoperative issues, recurrence rate were evaluated between two groups. Result：In the Thulium laser group, operation time was 21.8±13.0min and the hemoglobin decrease was （0.69±0.38）g, there were no obturator nerve reflections and one case with bladder perforation did not need further operation. In the TURBT group, operation time was （17.6±1l. 5）min and the hemoglobin decrease was （1.17±0.57） g. There were 10 cases occurred obturator nerve reflection, Two cases needed open conversion. During 2-24 months follow-up, 6 cases relapsed in Thulium laser group and 10 in TURBT group. Conclusion：Par- tial cystectomy with Thulium laser can treat bladder carcinoma safely and effectively. Comparing with TURBT, Thulium laser has some advantages, such as less blood loss, no obturator nerve reflection, fewer complications. however, partial eystectomy with Thulium laser can not replace TURBT completely.