经尿道钬激光切除术与等离子电切术治疗非肌层浸润性膀胱癌的疗效分析

Comparison of efficacy between transurethral holmium laser resection and plasmakinetic resection in the treatment of non-muscle invasive bladder cancer

目的比较经尿道钬激光切除术与等离子电切术治疗非肌层浸润性膀胱癌(NMIBC的疗效及安全性,为相关临床治疗提供数据支持。方法回顾性分析我院行经尿道钬激光膀胱肿瘤切除术(HOLRBT)的30例NMIBC患者和同期接受经尿道膀胱肿瘤等离子电切术(TURBT)的35例NMIBC患者的临床资料。比较两组围手术期的相关指标、手术并发症、肿瘤复发率等。结果 HOLRBT组和TURBT组患者的术后住院时间分别为(4.5±1.9)和(6.6±1.4)d,留置尿管时间分别为(3.5±0.6)和(5.3±1.1)d,住院费用分别为(15 478.2±385.9)和(12 347.6±457.8)元,闭孔神经反射发生率分别为0%(0/30)和34.29%(12/35),两组间比较差异均有统计学意义(P<0.05);HOLRBT组膀胱穿孔发生率为0%(0/30),低于TURBT组的5.71%(2/35),但差异无统计学意义(P>0.05)。两组患者术后随访12～37个月,平均(19.6±7.2)个月,HOLRBT组患者1年内及总随访期内肿瘤复发率分别为6.67%(2/30)和13.33%(4/30),均低于TURBT组的20.00%(7/35)和25.71%(9/35),但差异无统计学意义(P>0.05)。结论HOLRBT治疗NMIBC具有安全性高、并发症少、疗效确切的优点,在NMIBC的临床治疗中具有较高应用价值,可作为治疗NMIBC的可行性手段,并加以推广。

Objective To compare the effect and safety between transurethral holmium laser resection and plasmakinetic resection in the treatment of non-muscle invasive bladder cancer (NMIBC), providing data support for clinical treatment. MethodsThe clinical data of 30 patients with NMIBC who underwent transurethral holmium laser resection of bladder tumor (HOLRBT) in our hospital and 35 patients who received transurethral resection of bladder tumor (TURBT) at the same time were retrospectively analyzed. The perioperative indicators, complications and tumor recurrence rate were compared between the two groups. ResultsThere was statistical difference ( P <0.05) between the two groups in the postoperative hospital stay (4.5±1.9) days (HOLRBT group) vs.(6.6±1.4) days (TURBT group), the placing urinary catheter time (3.5±0.6) days (HOLRBT group) vs.(5.3±1.1) days (TURBT group), the hospitalization expenses (15 478.2±385.9) yuan (HOLRBT group) vs.(12 347.6±457.8) yuan (TURBT group), the obturator nerve reflex incidence 0%(HOLRBT group) vs.34.29%(TURBT group). There was no significant difference ( P >0.05) between the two groups in the bladder perforation incidence 0%(HOLRBT group) vs.5.71%(TURBT group).All patients of the two groups were followed up for 12-37 months, and the average was (19.6±7.2) months. The tumor recurrence rates of HOLRBT group were 6.67% within one year and 13.33% during the total follow-up period, while those in TURBT group were 20.00% and 25.71% respectively. The tumor recurrence rates of HOLRBT group within one year and total follow-up period were less than those of TURBT group, but there was no significant difference ( P >0.05) between the two groups. ConclusionsHOLRBT has superiority in safety, effectiveness and fewer complications in the treatment of NMIBC. It has high application value in the clinical treatment of NMIBC, so it can be used as a feasible way to treat NMIBC.