经尿道膀胱肿瘤等离子整块剜除术与传统电切术的对比研究

doi:10.19558/j.cnki.10-1020/r.2020.02.010

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摘要 目的：对比经尿道膀胱肿瘤等离子整块剜除术(TeURBT)与传统经尿道膀胱肿瘤电切术(TURBT)的疗效及安全性。方法：选取2017年1月–2018年10月诊断为非肌层浸润性膀胱癌,行经尿道膀胱肿瘤切除术的患者232例,其中行经尿道膀胱肿瘤整块剜除术(TeURBT组)患者123例,行传统经尿道膀胱肿瘤电切术(TURBT组)患者109例,分别比较两组患者的手术时间、术中出血量、术中闭孔神经反射及膀胱穿孔的发生率,术后3个月、6个月、1年的肿瘤复发率。结果：TeURBT组平均手术时间长于TURBT组,差异有统计学意义(P<0.01),TeURBT组术中出血明显少于TURBT组（P<0.01）,两组患者术中闭孔反射发生率差异无统计学意义,TeURBT组膀胱穿孔率低于传统TURBT组,差异有统计学意义（P<0.05）,TeURBT组术后可以准确诊断分期,两组患者术后3个月复查均未发现肿瘤复发,两组患者术后6个月肿瘤复发率无显著差异,TeURBT组术后1年肿瘤复发率低于传统TURBT组,差异有统计学意义（P<0.05）。结论：经尿道膀胱肿瘤等离子整块剜除术可以准确获得肿瘤的病理分期,降低肿瘤复发率及进展风险,手术效果确切,值得临床推广应用。

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	王伟
	周红庆
	刘明生
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关键词 ：膀胱肿瘤, 经尿道膀胱肿瘤整块剜除术, 膀胱肿瘤电切术

Abstract：Objective：To compare the efficacy and safety of transurethral en-bloc resection of bladder tumor and traditional transurethral resection of bladder tumor (TURBT). Methods： From January 2017 to October 2018, 232 patients with non-muscular invasive bladder cancer underwent transurethral cystectomy, and divided into transurethral en-bloc resection of bladder tumor group (TeURBT group, n=123), and traditional transurethral resection of bladder tumor group (TURBT group, n=109). The operation time, blood loss, obturator nerve reflex and bladder perforation were compared between the two groups. The recurrence rate of tumors at 3rd month, 6th month and 1st year after operation were compared between the two groups. Results： The average operation time of TeURBT group was significantly longer than that of TURBT group (P < 0.01). Intraoperative bleeding in TeURBT group was significantly less than that in TURBT group (P < 0.01). There was no significant difference in the incidence of obturator reflex between the two groups. The bladder perforation rate in TeURBT group was significantly lower than that in traditional TURBT group (P < 0.05). Postoperative pathological examination in TeURBT group could accurately diagnose the stage of bladder cancer. No recurrence of tumors was found in the two groups after 3 months of follow-up. There was no significant difference in tumor recurrence rate between the two groups at 6th month after operation. The recurrence rate of one year after operation in TeURBT group was significantly lower than that in traditional TURBT group (P < 0.05). Conclusion： Transurethral resection of bladder tumor by plasma can obtain accurate pathological stage and reduce the risk of recurrence and progression. The results of the operation are accurate and worthy of clinical application.

Key words： bladder tumor transurethral en-bloc resection of bladder tumor transurethral resection of bladder tumor

收稿日期: 2019-04-10

ZTFLH:

R737.14

通讯作者: 刘明生,18908741981@189.cn

引用本文:

王伟, 周红庆, 刘明生, 邵涛. 经尿道膀胱肿瘤等离子整块剜除术与传统电切术的对比研究[J]. 微创泌尿外科杂志, 2020, 9(2): 115-119.
WANG Wei, ZHOU Hongqing, LIU Mingsheng, SHAO Tao. Comparative analysis of transurethral en-bloc resection of bladder tumor by plasma and transurethral resection of bladder tumor. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(2): 115-119.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1582.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2020/V9/I2/115

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