浅表性膀胱肿瘤的腔内手术治疗

Comparison of endoscopic resection and vaporization for superficial bladder cancer

目的 评价浅表性膀胱肿瘤腔内手术的方法与临床价值。方法 回顾分析腔内治疗浅表性膀胱肿瘤 396例 ,其中 180例行经尿道膀胱肿瘤电切术 (TURBT) ,2 16例行经尿道膀胱肿瘤电汽化术 (TVBT) ,对两组的手术时间、手术中出血量、并发症发生率、术后肿瘤复发率等进行比较。结果TVBT组在术中出血量、并发症等方面明显优于TURBT组 ,且TVBT视野清晰 ,操作简便。两组在手术时间、肿瘤复发率方面无显著差别。结论 TVBT具有手术时间短、术中出血少和并发症少等优点 ,具有较好的治疗效果和临床价值。

Objective To evaluate the method and clinical value of endoscopic surgery by comparing endoscopic resection and vaporization for superficial bladder tumor. Methods 396 patients with superficial bladder papillary transitional cell carcinoma were treated by endoscopic therapy. 180 patients (Group A) were treated by transurethral resection of bladder tumor (TURBT) and 216 (Group B) by transurethral vaporization of bladder tumor (TVBT). Periodic postoperative intra vasicular instillation of chemotherapy was given to both groups. Operating time, amount of bleeding during operation, complications and recurrence rate were compared. Results In group B, the amount of bleeding and complications during operation were lower than those in group A, but TVBT rated better by clearer view and simplicity in maneuver. The operating time, recurrence rate in group B were similar to those in group A. Conclusion Transurethral vaporization of bladder cancer, with simplicity in maneuver, less bleeding and fewer complications, rates better in effectiveness and clinical value than resection. [