经尿道钬激光黏膜下剥离术与双极等离子电切治疗非肌层浸润性膀胱癌临床对比分析

Clinical comparative analysis of transurethral holmium laser submucosal dissection and bipolar plasma electrotomy for the treatment of non-muscular infiltrative bladder carcinoma

目的对比分析经尿道钬激光黏膜下剥离术与双极等离子电切治疗非肌层浸润性膀胱癌(NMIBC)的临床效果。方法选取2012年9月～2016年1月在我院进行手术治疗的符合纳入标准的非肌层浸润性膀胱癌患者92例,按照手术方法不同,随机分为观察组与对照组。观察组45例,采用经尿道钬激光膀胱肿瘤黏膜下剥离术(HoLBTSD)。对照组47例,采用经尿道双极等离子电切术(TURBT)。对比两组患者术中手术时间、术中出血量、住院时间、术后主要并发症发生率及1年、2年肿瘤复发率等情况。结果两组在手术时间、总住院费用、尿道狭窄发生率方面无明显统计学差异(P>0.05),在术中出血量、闭孔反射发生率、膀胱穿孔发生率、住院时间、1年肿瘤复发率、2年肿瘤复发率方面均明显低于对照组(P<0.05)。结论经尿道钬激光膀胱肿瘤黏膜下剥离术治疗非肌层浸润性膀胱癌并发症少,病人恢复快、出院早、术后复发率低,可作为NMIBC患者手术治疗的优先选择。

Objective To compare the clinical efficacy of transurethral holmium laser submucosal dissection and bipolar plasma transection in the treatment of non muscle invasive bladder cancer(NMIBC).Methods Ninety-two patients with non muscular invasive bladder cancer who were treated in our hospital from September 2012 to Month 2016 were randomly divided into observation group and control group,observation group 45 cases and control group 47 cases according to operation method.The observation group underwent transurethral Holmium Laser bladder tumor submucosal dissection(HOLBTSD),while the control group was treated with transurethral bipolar plasma resection(TURBT).The operation time,intraoperative bleeding,hospitalization time,main complication rate and 1 year and 2 years recurrence rate were compared between the two groups.Results There was no significant difference in the operation time,total hospitalization cost,and incidence of urethral stricture between the two groups(P>0.05).The intraoperative blood loss,the incidence of obturator reflex,the incidence of bladder perforation,the length of hospital stay,and the 1 year tumor recurrence rate and the 2 years tumor recurrence rate were significantly lower than those in the control group(P<0.05).Conclusion Transmucosal holmium laser tumor submucosal dissection for the treatment of non-muscle invasive bladder cancer has fewer complications,rapid recovery,early discharge,and low postoperative recurrence rate,which can be used as a priority for surgical treatment of NMIBC patients.