浅表性膀胱癌二次经尿道电切的意义

The significance of second-transurethral resection in superficial bladder cancer

目的:探讨对表浅性膀胱癌实施二次经尿道膀胱肿瘤电切术的指征和意义。方法:以确立的二次经尿道膀胱肿瘤电切术入选标准对126例表浅性膀胱癌患者实施手术,满足条件的81例患者中32例拒绝二次手术为A组,49例在术后4周行二次经尿道膀胱肿瘤电切术为B组,2组患者术后膀胱灌注相同。所有患者随访2年,比较2组间膀胱肿瘤进展率和复发率。结果:A组患者在术后2年随访中共有14例出现复发,分别为术后半年3例,1年内8例,1年至2年间6例。B组的16.3%(8/49)患者在第二次手术时发现肿瘤。2年随访期间复发8例,其中1年内3例,1年后5例,2组间在肿瘤复发上有统计学差异。结论:二次经尿道膀胱肿瘤电切术能降低非肌层浸润性膀胱癌患者的肿瘤复发;切除标本中有无肌层是明确手术切除彻底的标志。经尿道膀胱肿瘤电切术需要经验丰富的医师实施。

Objective：To study the indication and significance of the second - transurethral resection of the blad-der tumor in superficial bladder cancer. Methods：All 81 patients meet the established inclusion criteria among 126 cases of superficial bladder cancer plan to undergo the second - TURBT. 32 patients refused second operation as the group A,49 cases in 4 weeks after operation for the second TURBT as group B. Two groups of patients perfuse of the same drug after operation. All patients were followed up for 2 years. The rate of progression and recurrence rate of the two groups were compared. Results：A total of 14 cases of recurrence in group A after 2 years followed up,3 cases of half a year,1 year in 8 cases,1 to 2 years in 6 cases after operation respectively. 16. 3% patients（8 / 49）were found the tumor in the second operation in group B. 8 cases of recurrence happened during 2 years follow - up,of which,1 year 3 cases,after 1 year 5 cases. There was statistical difference in tumor recurrence between the two groups. Conclu-sion：Second TURBT can reduce the recurrence in the NMIBC patients;the existing muscle layer in specimen is a clear sign of complete resection in operation.