T1G3期膀胱癌2种电切方式的二次电切疗效比较

Comparision of the second electric resection effects of two kinds of endoscopic resection in T1G3 bladder cancer

目的：比较T1G3期膀胱癌2种电切方式的二次电切临床疗效。方法：将初次经尿道膀胱肿瘤电切术（ TURBT）术后病理诊断为T1G3期膀胱癌患者82例,随机分为2组,术后4周内行第二次电切,其中38例行 TURBT,44例行经尿道等离子电切术。比较2组手术时间、术后膀胱冲洗时间、闭孔神经反射率、肌层缺失率及二次电切术后病理分期。结果：2组患者手术时间、术后膀胱冲洗时间、闭孔神经反射率和肌层缺失率差异均有统计学意义（P＜0.05-P＜0.01）。二次电切术后病理分期差异无统计学意义（P〉0.05）。结论：PKRBT出血少、切割层次清晰,可缩短手术时间及术后膀胱冲洗时间,降低术中闭孔神经反射,提高肿瘤病理分期准确性。

Objective：To evaluate the clinical effects of the second electric resection of two kinds of endoscopic resection in T1G3 bladder cancer. Methods：Eighty-two T1G3 bladder cancer patients diagnosed by pathological results of the first transurethral resection of bladder tumor（TURBT） were randomly divided into group A（38 cases） and group B（48 cases）. Within postoperative 4 weeks,the group A and group B were treated with the second TURBT and transurethral plasma kinetic resection of bladder tumor,respectively. The time of operation and postoperative bladder irrigation, obturator nerve reflex rate, muscle layer lack rate and second postoperative pathological staging between two groups were compared. Results：The differences of the time of operation and postoperative bladder irrigation,obturator nerve reflex rate and muscle layer lack rate between two groups were statistically significant （ P 〈0. 05 to P 〈0. 01）. The difference of the second postoperative pathological staging between two groups was not statistically significant（P〉0. 05）. Conclusions：The TURBT is less bleeding, clear cutting layer and good clinical effects, which can short the time of operation and postoperative bladder irrigation,reduce the obturator nerve reflex and improve the accuracy of tumor pathological stage.