经尿道针状电极膀胱肿瘤整块切除术降低非肌层浸润性膀胱癌术后复发率的研究

doi:10.19558/j.cnki.10-1020/r.2020.02.009

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摘要 目的：比较经尿道针状电极膀胱肿瘤整块切除术与传统经尿道膀胱肿瘤电切术对非肌层浸润性膀胱癌复发率的影响。方法：回顾性分析2013―2017年接受手术治疗的155例非肌层浸润性膀胱癌患者的临床资料,根据手术方法分为经尿道针状电极膀胱肿瘤整块切除组（ERBT组）和传统经尿道膀胱肿瘤电切组（TURBT组）,比较两组患者的2年复发率,并通过多因素logistic分析探讨影响非肌层浸润性膀胱癌术后复发的因素。结果：ERBT组患者两年复发率12.5%,TURBT组患者两年复发率34.3%,差异有统计学意义（P<0.05）。Logistic分析提示手术方式（OR=3.185）、肿瘤病理分级（OR=3.754）、病变大小（OR=1.766）及肿瘤数目（OR=2.721）为膀胱癌术后复发的危险因素。结论：与传统电切术比较,经尿道针状电极膀胱肿瘤整块切除术可以降低非肌层浸润性膀胱癌术后复发率。

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	贾毅
	李守宾
	刘俊江
	郭留雄
	孙福振
	魏东
	谷守义
	王刚
	张盼英
	李静坡

关键词 ：膀胱肿瘤整块切除术, 针状电极, 非肌层浸润性膀胱癌, 复发, 经尿道膀胱肿瘤电切术

Abstract：Objective： To compare the effect of transurethral en bloc resection of bladder tumor by pin-shaped electrode with conventional transurethral resection of bladder tumor on the recurrence rate of non muscular-invasive bladder cancer. Methods： 155 patients with non muscular-invasive bladder cancer who underwent surgical treatment from 2013 to 2017 were retrospectively analyzed. According to the surgical methods, the patients were divided into two groups: transurethral en bloc resection of bladder tumor by pin-shaped electrode group (ERBT group) and conventional transurethral resection of bladder tumor group (TURBT group). The recurrence rate in two groups were analyzed, and multivariable logistic analysis was used to find the predictors of recurrence. Result： Of the 155 patients 56 received ERBT and 99 received TURBT. The 56 patients who received ERBT had a lower recurrence rate than the 99 who received TURBT (12.5% vs. 34.3%, P < 0.05). Multivariable logistic analysis showed that surgical method (OR=3.185), pathological grade (OR=3.754), size of lesion (OR=1.766) and number of tumors (OR=2.721) were the risk factors for recurrence of bladder cancer. Conclusion： Patients who received en bloc resection of bladder tumor by pin-shaped electrode had a lower incidence of recurrence than those who received conventional transurethral resection of bladder tumor.

Key words： en bloc resection of bladder tumor pin-shaped electrode non muscle-invasive bladder cancer recurrence transurethral resection of bladder tumor

收稿日期: 2019-08-20

ZTFLH:	R699.5
	R737.14

通讯作者: 李守宾,lishoubin@163.com;刘俊江,liujunjiang67@163.com

引用本文:

贾毅, 李守宾, 刘俊江, 郭留雄, 孙福振, 魏东, 谷守义, 王刚, 张盼英, 李静坡. 经尿道针状电极膀胱肿瘤整块切除术降低非肌层浸润性膀胱癌术后复发率的研究[J]. 微创泌尿外科杂志, 2020, 9(2): 110-114.
JIA Yi, LI Shoubin, LIU Junjiang, GUO Liuxiong, SUN Fuzhen, WEI Dong, GU Shouyi, WANG Gang, ZHANG Panying, LI Jingpo. Transurethral en bloc resection of bladder tumor by pin-shaped electrode is associated with lower recurrence rate after resection of non muscle-invasive bladder cancer. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(2): 110-114.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1581.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I2/110

[1] 那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南手册.北京:人民卫生出版社,2014:25.
[2] ENGILBERTSSON H, AALTONEN KE, BJORNSSON S, et al.Transurethral bladder tumor resection can cause seeding of cancer cells into the bloodstream. J Urol, 2015,193(1):53-57.
[3] AKAND M, MUILWIJK T, RASKIN Y, et al.Quality control indicators for transurethral resection of non-muscle-invasive bladder cancer. Clin Genitourin Cancer, 2019,17(4):e784-e792.
[4] 李守宾,刘俊江,孙福振,等.针状电极膀胱肿瘤剜除术与传统膀胱肿瘤电切术的初步比较.河北医科大学学报,2016,37(10):1135-1138.
[5] LOPEZ-BELTRAN A, MONTIRONI R.Non-invasive urothelial neoplasms: according to the most recent WHO classification. Eur Urol, 2004,46(2):170-176.
[6] FANG D, LI XS, XIONG GY, et al.Prophylactic intravesical chemotherapy to prevent bladder tumors after nephroureterectomy for primary upper urinary tract urothelial carcinomas: a systematic review and meta-analysis. Urol Int, 2013,91(3):291-296.
[7] 薛炜,邱建新,桑楠,等.影响非肌层浸润性膀胱癌患者经尿道膀胱肿瘤电切术后复发的相关因素分析.实用医院临床杂志,2019,16(5):30-33.
[8] LU M, CHEN S, ZHOU Q, et al.Predicting recurrence of nonmuscle-invasive bladder cancer(Ta-T1): A study based on 477 patients. Medicine (Baltimore), 2019,98(28):e16426.
[9] DUTTA SC, SMITH JA, SHAPPELL SB, et al.Clinical under staging of high risk nonmuscle invasive urothelial carcinoma treated with radical cystectomy. J Urol, 2001,166(2):490-493.
[10] NASELLI A, PUPPO P.En bloc transurethral resection of bladder tumors: a new standard? J Endourol, 2017,31(S1):S20-S24.
[11] UKAI R, KAWASHITA E, IKEDA H.A new technique for transurethral resection of superficial bladder tumor in 1 piece. J Urol, 2000,163(3):878-879.
[12] 宋伟宁,徐阿祥,孙圣坤,等.经尿道针状电极膀胱部分切除术治疗膀胱尿路上皮癌(附4例报告).微创泌尿外科杂志,2013,2(6):396-398.
[13] HURLE R, LAZZERI M, COLOMBO P, et al."En bloc" resection of nonmuscle invasive bladder cancer: a prospective single-center study. Urology, 2016,90:126-130.
[14] MUTO G, COLLURA D, GIACOBBE A, et al.Thulium: yttrium-aluminum-garnet Laser for En Bloc Resection of Bladder Cancer: Clinical and Histopathologic Advantages. Urology, 2014,83(4):851-855.
[15] HAYASHIDA Y, MIYATA Y, MATSUO T, et al.A pilot study to assess the safety and usefulness of combined transurethral endoscopic mucosal resection and en-bloc resection for non-muscle invasive bladder cancer. BMC Urol, 2019,19(1):56.
[16] LIU H, WU J, XUE S, et al.Comparison of the safety and efficacy of conventional monopolar and 2-micron laser transurethral resection in the management of multiple nonmuscle-invasive bladder cancer. J Int Med Res, 2013,41(4):984-992.
[17] KOUMPAN Y, JAEGER M, MIZUBUTI GB, et al.Spinal anesthesia is associated with lower recurrence rates after resection of nonmuscle invasive bladder cancer. J Urol, 2018,199(4):940-946.
[18] MORI K, D'ANDREA D, ENIKEEV DV, et al. En bloc resection for nonmuscle invasive bladder cancer: review of the recent literature. Curr Opin Urol, 2020,30(1):41-47.
[19] ZHANG KY, XING JC, LI W, et al.A novel transurethral resection technique for superficial bladder tumor: retrograde en bloc resection. World J Surg Oncol, 2017,15(1):125-132.
[20] 闫伟,乔庐东,杜震,等.经尿道双极等离子针状电极肿瘤整块切除术治疗非肌层浸润性膀胱尿路上皮癌的临床分析.中华泌尿外科杂志,2016,37(9):672-676.