经尿道双波长激光整块汽化剜除术对非肌层浸润性膀胱肿瘤的疗效分析

Curative effect analysis of the enbloc transurethral resection with dual laser in the treatment of non-muscle invasive bladder tumor

目的对比研究经尿道双波长激光整块汽化剜除术与经尿道电切在浅表性膀胱肿瘤中的疗效。方法收集35例浅表性膀胱肿瘤患者,随机分为两组,观察组20例行经尿道双波长激光整块汽化剜除术,对照组15例行经尿道膀胱肿瘤电切术,对比分析两组术中及术后情况,两组术后定期膀胱灌注化疗,随访1年并评价其临床疗效。结果两组手术时间相比差异无统计学意义(P>0.05);膀胱穿孔发生率无法进行统计学比较;而在术后导尿管留置时间[(38.9±14.9)h vs.(65.2±31.3)h,P=0.002]、术后肉眼血尿持续时间[(26.2±17.9)h vs.(47.9±28.87)h,P=0.010]、术后1年肿瘤复发率[5(1/20)%vs.40%(6/15),P=0.023]比较差异有统计学意义,观察组优于对照组。结论经尿道双波长激光整块汽化剜除术在浅表性膀胱肿瘤的治疗上安全、有效,但其远期随访结果有待进一步证实。

Objective To compare the clinical efficacy of en bloc transurethral resection with dual laser and transurethral resection of bladder tumor(TURBT)in the treatment of non-muscle invasive bladder cancer(NMBIC).Methods A total of 35 patients with non-muscle invasive bladder cancer(NMBIC)were randomly divided into two groups,20 cases in the observation group underwent en bloc transurethral resection with dual laser and 15 cases in the control group underwent TURBT.Intraoperative and postoperative records were compared between the two groups.Regular bladder intravesical instillation therapy were executed after operation in both groups.All patients were followed 1 year and the clinical efficacy was evaluated.Results There were no significant differences in the operation time(P>0.05).No statistical comparison was possible in the bladder perforation probabilities.The dual laser group was superior to the TURBT group in terms of urethral catheterization[(38.9±14.9)h vs.(65.2±31.3)h,P=0.002],postoperative gross hematuria time[(26.2±17.9)h vs.(47.9±28.87)h,P=0.010],Recurrence 1 year after operation[5%vs.40%,P=0.023].Conclusions En bloc transurethral resection with dual laser in the treatment of non-muscle invasive bladder cancer is safe and effective,however,the long-term follow-up results need further confirmation.