半导体激光和等离子电切术治疗非肌层浸润性膀胱癌的疗效比较

Comparison of the clinical efficacy of semiconductor laser and plasma electrotomy in the treatment of non-muscle invasive bladder cancer

目的比较1470nm半导体激光和等离子电切术治疗非肌层浸润性膀胱癌的有效性和安全性。方法选取2015年1月至2017年6月曾就诊于我院的非肌层浸润性膀胱癌患者43例进行回顾性分析,根据手术方式的不同纳入激光剜除组(激光组)20例和等离子电切组(电切组)23例,对比两组患者的手术时间、术中出血量、术中闭孔神经反射发生率、保留导尿时间、术后膀胱冲洗时间、平均住院天数和术后2年肿瘤复发率等。结果术中出血量、保留导尿时间比较,激光组与电切组差异均无统计学意义(P>0.05);而手术时间、术后膀胱冲洗时间、平均住院天数、术中闭孔神经反射发生率,激光组均少于电切组(均P<0.05)。随访情况:术后1年,激光组肿瘤复发率为0,而电切组复发率为8.69,组间差异无统计学意义(P>0.05);术后第2年:激光组的肿瘤复发率低于电切组[0vs.26.08%(6/23)],差异有统计学意义(P<0.05)。结论1470nm半导体激光在有效性和安全性上要优于传统的等离子电切,值得在临床上推广运用。

ObjectiveTo compare the efficacy and safety of 1 470 nm semiconductor laser and plasma electrotomy in the treatment of non-muscle invasive bladder cancer. MethodsThe clinical data of 43 patients with non-muscle invasive bladder cancer treated during Jan.2015 and Jun.2017 were retrospectively analyzed,including 20 cases treated with 1 470 nm semiconductor laser and 23 cases treated with plasma electrotomy.The operation time,intraoperative blood loss,incidence of obturator nerve reflex,catheter indwelling time,postoperative bladder irrigation time,average hospital stay,and 2-year recurrence rate were compared between the two groups. ResultsThere were no significant differences in intraoperative blood loss and catheter indwelling time between the two groups (both P>0.05).The laser group had shorter operation time,bladder irrigation time and average hospital stay,and lower incidence of obturator nerve reflex than the plasma electrotomy group (all P<0.05).After 1 year follow-up,the recurrence rate was 0 in the laser group and 8.69%(2/23) in the plasma electrotomy group (P>0.05).In the second year after operation,the recurrence rate was 0 in the laser group and 26.08%(6/23) in the electrotomy group (P<0.05). ConclusionThe 1 470 nm semiconductor laser is more effective and safe than traditional plasma electrotomy in the treatment of non-muscle invasive bladder cancer,and is worthy of clinical application.