经尿道双极等离子整块剜除术治疗非肌层浸润性膀胱癌的临床观察

Clinical observation of en-bloc resection of bladder tumor for non-muscular invasive bladder cancer

目的探讨对非肌层浸润性膀胱癌(NMIBC)行经尿道双极等离子整块剜除术(ERBT)治疗的临床疗效。方法30例非肌层浸润性膀胱癌患者,采用随机数字表分组法分成对照组和观察组,每组15例。对照组行经尿道膀胱肿瘤电切术(TURBT)。观察组行经尿道双极等离子整块剜除术。比较两组患者手术临床指标、术后不良事件发生率。结果观察组手术时间(55.28±8.48)min、留置导尿管时间(5.84±1.54)d、住院时间(7.54±1.54)d均短于对照组的(85.54±10.48)min、(10.54±2.40)d、(13.54±2.51)d,手术出血量(45.28±8.54)ml少于对照组的(85.54±12.54)ml,差异具有统计学意义(P<0.05)。观察组术后不良事件发生率为20.00%,低于对照组的66.67%,差异具有统计学意义(P<0.05)。结论对非肌层浸润性膀胱癌行经尿道双极等离子整块剜除术治疗,能明显缩短手术治疗时间、导尿管留置时间及住院时间,减少出血量,降低术后不良事件发生率,此术式肌层取样率更高,且有完整的组织标本,有利于精确病理诊断,对肿瘤临床分期、预后评估以及后续治疗提供了有力的支持。此术式值得广泛开展,具有较高临床推广价值。

Objective To discuss the clinical efficacy of en-bloc resection of bladder tumor(ERBT)for non-muscular invasive bladder cancer(NMIBC).Methods A total of 30 patients with non-muscular invasive bladder cancer were divided into control group and observation group according to random numerical table,with 15 cases in each group.The control group was treated with transurethral resection of bladder tumor(TURBT),and the observation group was treated with en-bloc resection of bladder tumor.The clinical indexes and incidence of adverse events were compared between the two groups.Results The operation time(55.28±8.48)min,catheter indwelling time(5.84±1.54)d and hospitalization time(7.54±1.54)d of the observation group were shorter than(85.54±10.48)min,(10.54±2.40)d and(13.54±2.51)d of the control group,and surgical blood loss(45.28±8.54)ml was less than(85.54±12.54)ml of the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative adverse events of the observation group was 20.00%,which was lower than 66.67% of the control group,and the difference was statistically significant(P<0.05).Conclusion En-bloc resection of bladder tumor for non-muscular invasive bladder tumors can significantly shorten operation time,catheter indwelling time and hospitalization time,and reduce blood loss and the incidence of postoperative adverse events.The muscular layer sampling rate is higher,and there are complete tissue samples,which is conducive to precise pathological diagnosis,and provides strong support for the clinical staging,prognosis assessment and follow-up treatment of tumors.This operation is worthy of being widely carried out and has high clinical promotion value.