经尿道钬激光膀胱肿瘤切除术与经尿道膀胱肿瘤电切术治疗表浅层膀胱癌的疗效和安全性:对比研究

Transurethral Holmium Laser Resection and Standard Transurethral Resection: A Comparison Study of Efficacy and Safety in Patients with Superficial Bladder Cancer

目的对比经尿道钬激光膀胱肿瘤切除术(HOLRBT)与经尿道膀胱肿瘤电切术(TURBT)治疗浅表层膀胱癌的疗效和安全性。方法选择2010年6月—2012年6月在我院进行手术治疗的表浅层膀胱癌患者251例,根据手术方法分为HOLRBT组125例和TURBT组126例。对比两组患者手术时间、术中出血量、膀胱冲洗时间、尿管留置时间、住院时间等及2年累积复发率。结果两组患者手术时间比较,差异无统计学意义(P>0.05);HOLRBT组患者术中出血量少于TURBT组,膀胱冲洗时间、尿管留置时间及住院时间均短于TURBT组(P<0.05)。HOLRBT组患者总并发症发生率低于TURBT组〔4.0%(5/125)与12.7%(16/126),χ2=6.193,P<0.05〕。HOLRBT组2年累积复发率为8.00%(10/125),TURBT组为16.67%(21/126),两组患者2年累积复发率曲线比较,差异有统计学意义(log-rankχ2=5.809,P<0.05)。结论 HOLRBT治疗表浅层膀胱癌疗效显著,安全可靠,值得临床推广应用。

Objective To explore the efficacy and safety of transurethral holmium laser resection of bladder cancer （HOLRBT） and standard transurethral resection of bladder cancer （TURBT） in patients with superficial bladder cancer （SBC）. Methods A total of 251 SBC patients having surgical treatment in this hospital from June 2010 to June 2012 were di- vided, according to surgical methods, into groups HOLRBT （n = 125）, TURBT （n = 126）. The operation time, blood loss, bladder irrigation time, catheter indwelling time, hospital stay, complications, 2 - year cumulative recurrence rate were com- pared between 2 groups. Results There was no significant difference in operation time between 2 groups （ P 〉 0. 05 ）. The blood loss was less, bladder irrigation time, catheter indwelling time, hospital stay shorter in HOLRBT group than in TURBT （P〈0.05）. The overall incidence of complications was lower in HOLRBT group than in TURBT group [4. 0% （5/125） vs. 12. 7% （16/126）, χ^2 =6. 193, P 〈0. 05]. The 2 -year cumulative recurrence rate was 8.00% （10/125） in HOLRBT group, 16. 67% （21/126） in TURBT group, there was difference in the curve of 2 - year recurrence rate between 2 groups （ log - rank χ^2= 5. 809, P 〈 0. 05 ）. Conclusion HOLRBT, safe and reliable with remarkable effect in the treatment of SBC, is worthy of clinical application.