不同手术方式治疗非肌层浸润性膀胱癌效果及安全性

Efficacy and Safety of Different Surgical Methods in the Treatment of Non-muscle Invasive Bladder Cancer

目的:探讨经尿道针状电极膀胱肿瘤整块切除术治疗非肌层浸润性膀胱癌(NMIBC)的效果及安全性。方法:选择笔者所在医院2016年6月-2018年6月收治的96例NMIBC患者为研究对象,按随机数字表法分为钬激光组和针状电极组,每组48例。钬激光组采用经尿道钬激光切除术治疗,针状电极组采用经尿道针状电极膀胱肿瘤整块切除术治疗。记录两组术后病理情况、手术时间、术中失血量、留置尿管时间、住院时间、住院费用、并发症发生率及随访1年复发率、生存率。结果:两组均顺利完成手术,术后患者症状均明显改善。两组术后病理诊断均为尿路上皮癌,标本完整且基底为肌层,病理层次清晰,切缘平整且均为阴性。两组肿瘤直径及术后病理分期比较,差异均无统计学意义(P>0.05)。两组手术时间、术中失血量、留置尿管时间、住院时间、并发症发生率、术后1年复发率及生存率比较,差异均无统计学意义(P>0.05)。针状电极组住院费用低于钬激光组,差异有统计学意义(P<0.05)。结论:经尿道针状电极膀胱肿瘤整块切除术治疗NMIBC具有较好的效果及安全性,住院费用较低,值得临床推广应用。

Objective: To explore the efficacy and safety of transurethral needle electrode resection of bladder cancer in the treatment of non-muscle invasive bladder cancer(NMIBC). Method: A total of 96 patients with NMIBC in our hospital from June 2016 to June 2018 were selected as the research objects. And patients were randomly divided into the holmium laser group and the needle electrode group, with 48 cases in each group. The holmium laser group was treated with transurethral holmium laser resection, while the needle electrode group was treated with transurethral needle electrode resection of bladder cancer. Postoperative pathological conditions, operative time, intraoperative blood loss, catheter indwelling time, hospitalization time, hospitalization costs, incidence of complications, recurrence rate and survival rate after 1 year were recorded between the two groups. Result: The surgery of both groups were successfully completed, postoperative patients’ symptoms were significantly improved. The postoperative pathological diagnosis of the two groups were urothelial carcinoma, and the specimens were intact and the basement were muscle layer, and the pathological layers were clear, the surgical margins were smooth and negative. The diameter of the cancer and postoperative pathologic staging were compared between the two groups, and the differences were not statistically significant(P>0.05). Operative time, intraoperative blood loss, catheter indwelling time, hospitalization time, incidence of complications, recurrence rate and survival rate after 1 year were compared between the two groups, and the differences were not statistically significant(P>0.05). The hospitalization costs of the needle electrode group was less than that of the holmium laser group(P<0.05). Conclusion: Transurethral needle electrode resection of bladder cancer in the treatment of non-muscle invasive bladder cancer is effective and safe. The hospitalization costs are less, which is worthy of clinical popularization and application.