根治性经尿道膀胱肿瘤切除术联合术后放化疗的“三联”模式在肌层浸润性膀胱癌保留膀胱治疗上的效果

Curative effect of triple mode of radical transurethral resection of bladder tumor combined with postoperative radiotherapy and chemotherapy in treatment of bladder preservation in myometrial invasive bladder cancer

目的研究肌层浸润性膀胱癌保留膀胱治疗中应用根治性经尿道膀胱肿瘤切除术联合术后放化疗的效果。方法选择我院2011年4月~2016年4月中的肌层浸润性膀胱癌患者68例,根据治疗方式分为两组,观察组接受根治性经尿道膀胱肿瘤切除术联合术后放化疗治疗,对照组直接实施膀胱部分切除术治疗,比较两组效果。结果观察组、对照组在手术时间、术中出血量、导尿管留置时间、术后住院时间比较,差异无统计学意义(P> 0.05);观察组术后并发症发生率为23.53%,对照组为26.47%,差异无统计学意义(P> 0.05);观察组术后2年的复发率为11.76%、生存率为82.35%,对照组分别为32.35%、58.82%,差异有统计学意义(P <0.05)。结论对于有膀胱保留需求的肌层浸润性膀胱癌患者,实施根治性经尿道膀胱肿瘤切除术联合术后放化疗治疗能减少术后复发,提升生存率,可推广。

Objective To study the curative effect of radical transurethral resection of bladder tumors combined with postoperative radiotherapy and chemotherapy in treatment of bladder preservation in myometrial invasive bladder cancer. Methods 68 patients with myometrial invasive bladder cancer in our hospital from April 2011 to April 2016 were selected and they were divided into two groups according to the treatment methods.The observation group was treated with radical transurethral resection of bladder tumors combined with postoperative radiotherapy and chemotherapy while the control group was treated with partial cystectomy directly.The curative effects of the two groups were compared. Results There were no statistically significant difference in operation time,intraoperative blood loss,indwelling time of catheter and postoperative hospital stay between the observation group and the control group(P > 0.05).The incidence of postoperative complications was 23.53% in the observation group and 26.47% in the control group,with no statistically significant difference(P > 0.05).The recurrence rate and survival rate of 2 two after treatment in the observation group were 11.76% and 82.35% respectively,while those of the control group were32.35% and 58.82% respectively.The differences were statistically significant(P < 0.05). Conclusion For patients with myometrial invasive bladder cancer who have requirements of bladder preservation,radical transurethral resection of bladder tumor combined with postoperative radiotherapy and chemotherapy can reduce postoperative recurrence and improve survival rate,which can be promoted.