经尿道等离子整块切除术治疗直径<2 cm非肌层浸润性膀胱肿瘤

Transurethral Plasmakinetic Electrode En-bloc Resection of Non-muscle Invasive Bladder Tumor Less Than 2 cm in Diameter

目的探讨经尿道等离子环状电极肿瘤整块切除术治疗直径<2 cm的非肌层浸润性膀胱肿瘤的临床疗效。方法将2016年4月～2018年5月42例直径<2 cm非肌层浸润性膀胱肿瘤随机分成2组各21例,分别行经尿道等离子肿瘤整块切除术(整块切除组)或经尿道膀胱肿瘤电切术(transurethral resection for bladder tumor,TURBT)(TURBT组),比较2组手术时间、术中出血量、手术并发症发生率及术后复发率。结果 2组手术时间、术中出血量、并发症发生率无统计学差异(P> 0. 05),但在术后复发率方面整块切除组优于TURBT组[4. 8%(1/21) vs. 33. 3%(7/21),log-rankχ~2=4. 670,P=0. 031]。结论经尿道等离子环状电极肿瘤整块切除术治疗直径<2 cm的非肌层浸润性膀胱肿瘤,复发率低,无膀胱穿孔及大出血等严重并发症,适合基层医院推广。

Objective To evaluate the clinical effect of transurethral en bloc resection by ring-shaped plasmakinetic electrode for the treatment of non-muscle invasive bladder tumor less than 2 cm in diameter. Methods A total of 42 cases confirmed as non-muscle invasive bladder tumor less than 2 cm in diameter from April 2016 to May 2018 were collected,and then were randomly divided into either en bloc resection group (n=21) or TURBT group (n=21).The en bloc resection group was treated with transurethral en bloc resection by ring-shaped plasmakinetic electrode,and the TURBT group was treated with transurethral resection for bladder tumor (TURBT).Then two groups of patients were compared in operation time,amount of bleeding,incidence of complications and recurrence rate. Results There was no statistical significance between the two groups in the operation time,bleeding volume and complications (P>0.05),but the postoperative recurrent rate in the en bloc resection group was superior to that in the TURBT group [4.8%(1/21) vs.33.3%(7/21),log-rank χ^2=4.670,P=0.031]. Conclusion Ring-shaped plasmakinetic electrode used in transurethral en bloc resection for the treatment of non-muscle invasive bladder tumor less than 2 cm in diameter has advantages of low recurrence rate,making it applicable in basic-level hospitals.