非肌层浸润性膀胱癌患者二次经尿道膀胱肿瘤摩西钬激光切除术的临床意义

Clinical significance of Moses holmium laser on re-transurethral resection of non-invasive muscle bladder tumor

目的探讨非肌层浸润性膀胱癌患者二次经尿道膀胱肿瘤摩西钬激光切除术的临床有效性。方法选取2018年3月—2019年8月徐州市肿瘤医院和大连医科大学附属第二医院61例行二次经尿道膀胱肿瘤切除术患者,依据手术方式不同,分为摩西钬激光组35例和经尿道膀胱肿瘤电切组(TURBT组)26例。比较两组患者手术时间、术中出血量、膀胱冲洗次数、病理结果准确率、术后随访期复发率。结果61例患者均成功完成手术。两组患者闭孔神经反射发生率比较,差异有统计学意义(P<0.05);两组患者手术时间、保留导尿时间、住院时间、膀胱冲洗次数比较,差异无统计学意义(P>0.05)。摩西钬激光组有33例符合病理分期要求,TURBT组10例符合。两组患者病理诊断准确率比较,差异有统计学意义(P<0.05)。所有患者术后随访时间3~14个月,平均(10.0±2.4)个月。摩西钬激光组肿瘤复发3例(8.6%,3/35),TURBT组复发2例(7.7%,2/26),差异无统计学意义(P>0.05)。结论经尿道摩西钬激光术应用于二次经尿道膀胱肿瘤切除术,手术安全、有效,切除标本满足病理分期要求。

Objective To evaluate the efficacy and safety of Moses holmium laser resection of bladder tumor for non-muscle-invasive bladder cancer.Methods From March 2018 to August 2019,61 cases with non muscle invasive bladder cancer treated in xuzhou cancer hospital and Secondary hospital of Dalian medical university were assigned to receive re-transurethral resection of bladder tumor.All the cases were divided into Moses group(n=35)and TURBT group(n=26).The operation time,dewelling catheter time,bladder irrigation time,the incidence of obturator reflex,the accuracy of pathology,and the recurrence rate in the follow-up period were compared between the two groups,and the data were statistically analyzed.Results All the cases were successfully undergone operation.There was significant difference in the incidence of obturator nerve reflex between the two groups(P<0.05).There was no significant difference in the operation time,dewelling catheter time,bladder irrigation time in the two groups(P>0.05).There were 33 cases in Moses group and 10 cases in TURBT group meet the requirement of pathological staging.The difference in pathological diagnosis accuracy was statistically significant between the two groups(P<0.05).All patients were followed up for 3 to 14 months,with an average of(10.0±2.4)months.The tumor recurrence was found in 3 cases in Moses group(8.6%,3/35)and 2 cases in the TURBT group(7.7%,2/26).There was no significant difference(P>0.05).Conclusion Moses holmium laser transurethral resection of bladder tumor is a safe and effective therapeutic method for non-muscle-invasive bladder cancer,which meet the needs of postoperative pathological diagnosis.