非肌层浸润性膀胱癌整块切除术的技术规范与临床挑战(“大家泌尿网”观看手术视频)

Technical specifications and clinical challenges of en bloc resection for non-muscle invasive bladder cancer

近年来,经尿道膀胱肿瘤整块切除术(ERBT)克服了既往传统电切术的诸多弊端,受到越来越多的关注,可能成为未来非肌层浸润性膀胱癌(NMIBC)的优选手术方式。该技术整块切除肿瘤,避免了肿瘤碎块化,而完整的肿瘤标本有助于准确的术后组织病理学诊断,更好地指导后续治疗,这些优势有望降低患者的复发率和进展率,继而给患者带来潜在的生存受益。但遗憾的是,目前ERBT仍面临高质量研究证据不足、手术方式多样、缺乏标准化的手术操作及术后疾病管理规范等诸多临床问题和挑战。对此,本文就ERBT的历史、现状以及发展趋势进行评述,以期获得更优的临床策略和更标准的技术规范,充分发挥其优势,提升NMIBC的临床诊治水平。

In recent years,en bloc resection of bladder tumour(ERBT)has overcome many disadvantages of previous transurethral resection and become the preferred way of operation for non-muscle invasive bladder cancer(NMIBC).ERBT avoids fragmentation,and the whole tumor specimen is helpful for accurate postoperative histopathological diagnosis and better guidance of followed treatment.These advantages are expected to translate into the reduction of tumor recurrence and progression rate,and bring potential survival benefits to patients.Unfortunately,ERBT is still facing many clinical problems and challenges,such as lack of high-quality research evidence,various surgical methods,standardized surgical procedures and postoperative disease management.This paper reviews the history,current situation and development trend of ERBT,hoping to obtain better clinical strategies and more standard technical specifications,which will help us to make full use of its advantages and improve the clinical diagnosis and treatment of NMIBC.