经尿道整块剜除术与经尿道膀胱肿瘤电切术在非肌层浸润性膀胱癌治疗中的疗效对比

Comparison of transurethral enucleation and cystectomy in the treatment of non-muscle invasive bladder cancer

目的对比经尿道整块剜除术(en bloc resection of bladder tumor,EBRBT)与经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)在非肌层浸润性膀胱癌(non-muscle invasive bladder cancer,NMIBC)治疗中的疗效。方法选取2021年4月至2023年2月于揭阳市人民医院接受手术治疗的58例NMIBC患者作为研究对象,按照计算机随机法分为EBRBT组和TURBT组,每组29例,分别行EBRBT和TURBT。观察两组患者围手术期指标、并发症、术后肌层侵犯率及术后1年肿瘤复发情况。结果两组手术时间差异无统计学意义(P>0.05);EBRBT组术中出血量为(10.71±4.78)ml,较TURBT组(16.58±6.27)ml少,EBRBT组术后尿管留置时间与住院时间分别为(3.23±1.66)d及(4.92±1.06)d,少于TURBT组的(4.75±1.71)d及(5.87±1.82)d,差异有统计学意义(P<0.05);EBRBT组术后并发症发生率为3.45%(1/29),比TURBT组的20.69%(6/29)低,差异有统计学意义(P<0.05);术后EBRBT组肌层侵犯率、肿瘤复发率分别为92.59%和6.9%,显著低于和TURBT组的62.07%和26.67%,差异有统计学意义(P<0.05)。结论EBRBT相较于TURBT安全性更好,患者预后效果更佳。

Objective To compare the efficacy of en bloc resection of bladder tumor(EBRBT)and transurethral resection of bladder tumor(TURBT)in the treatment of non-muscle invasive bladder cancer(NMIBC).Method Totally 58 patients with NMIBC who underwent surgical treatment at Jieyang People's Hospital from April 2021 to February 2023 were selected as the study subjects.They were randomly divided into EBRBT group and TURBT group according to computer randomization respectively,with 29 cases in each group.Perioperative indicators,postoperative complications,postoperative muscle invasion rate,and tumor recurrence at 1 year after surgery in two groups of patients were observed.Results The difference in surgical time between the two groups was not statistically significant(P>0.05).The intraoperative bleeding volume of EBRBT group was significantly less than that of TURBT group[(10.69±4.87)ml vs.(16.61±6.33)ml].The postoperative indwelling time and hospitalization time were(3.23±1.66)days and(4.92±1.06)days in EBRBT group,respectively,which were less than those of the TURBT group[(4.75±1.71)days and(5.87±1.82)days](P<0.05).The incidence of postoperative complications in the EBRBT group was 3.45%(1/29),which was lower than 20.69%(6/29)in the TURBT group,and the difference was statistically significant(P<0.05).The postoperative muscle invasion rate and tumor recurrence rate in the EBRBT group were 92.59%and 6.9%,respectively,significantly lower than those in the TURBT group(62.07%and 26.67%),and the differences were statistically significant(P<0.05).Conclusion EBRBT is safer and has a better prognosis for patients compared to TURBT.