双波长龙激光整块剜除与经尿道等离子电切治疗非肌层浸润性膀胱癌的疗效比较

Efficacy comparison of en bloc resection by dual-wavelength laser and plasma electromy in the treatment of non-muscle invasive bladder cancer

目的:比较980/1 470 nm双波长龙激光整块剜除术与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的安全性与临床疗效。方法:选取2019年1月至2022年9月就诊我科的非肌层浸润性膀胱癌患者90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)44例和等离子电切组(电切组)46例,对比两组患者的术后血红蛋白改变、手术时间、术后平均住院天数、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、手术费用和术后3月~2年肿瘤复发率等。结果:手术时间、术后冲洗时间、术后住院时间、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);而血红蛋白改变、手术费用、术中闭孔神经反射发生率、复发率,激光组均少于电切组(均P<0.05)。随访情况:术后3月~2年,激光组肿瘤复发率为9.1%,而电切组复发率为26.1%,组间差异有统计学意义(P<0.05)。结论:980/1 470 nm双波长龙激光整块剜除术在降低手术费用的同时提高了手术的有效性和安全性,临床上值得推广。

Objective:To evaluate clinical efficacy of en bloc resection by 980/1470 nm laser and plasma electromy in the treatment of non-muscle invasive bladder cancer.Methods:The clinical data 90 patients with non-muscle invasive bladder cancer treated during January 2019 and September 2022 were retrospectively analyzed,including 44 cases treated with 980/1470 nm laser and 46 cases treated with plasma electrotomy.The operation time,hemoglobin drop value,incidence of obturator nerve reflex,catheter indwelling time,postoperative bladder irrigation time,average hospital stay,surgery cost,and 3-month to 2-year recurrence rate were compared between the two groups.Results:There were no significant differences in the operation time,average hospital stay,catheter indwelling time and postoperative bladder irrigation time between the two groups(all P>0.05).The laser group had shorter hemoglobin drop value and surgery cost,tumor recurrence rate and incidence of obturator nerve reflex were lower than plasma electromy group(all P<0.05).3 months to 2 years after surgery,the recurrence rate of tumor was 9.1%in the laser group and 26.1%in the electrical resection group,the difference between groups was statistically significant(P<0.05).Conclusion:The 980/1470 nm laser is more effective and safe than tradional plasma electromy in the treatment of non-muscle invasive bladder cancer,and is worthy of clinical application.