Abstract:Objective: To investigate the difference in efficacy between transurethral holmium laser resection of bladder tumor (THLRBT) and transurethral resection of bladder tumor (TURBT) in the treatment of superficial bladder cancer (SBC) and the effects on urinary function and quality of life. Methods: 105 patients with SBC who underwent surgery combined with bladder perfusion were selected from January 2014 to January 2016. According to the surgical methods, the patients were divided into the TURBT group (63 cases, TURBT) and the THLRBT group (42 cases). The basic data and complications in two groups were compared, and the differences in urinary function and quality of life between two groups were observed before and after surgery. The tumor recurrence and progression in two groups 2 years after surgery were statistically analyzed. Results: The operation time, blood loss, time to get out of bed, indwelling time of catheter and hospital stay in THLRBT group were significantly reduced as compared with those in TURBT group (P < 0.05), and the incidence rate of surgical complications was significantly lower in THLRBT group than in TURBT group (P < 0.05). There was no significant difference in the recurrence rate, progression rate and recurrence time between two groups two years after surgery (P > 0.05). The Qmax and maximum detrusor pressure in THLRBT group were greater than those in TURBT group 1 month after surgery, while the PVR was less than TURBT group (P < 0.05). The quality of life scores in THLRBT group were significantly higher than those in TURBT group 6 month after surgery (P < 0.05). Conclusion: THLRBT is effective in treatment of SBC, which can effectively reduce surgical complications, avoid urinary function injury and improve the quality of life.
白冰, 母健君, 王岭, 高建勇, 郑小敏, 雷弋. 两种经尿道膀胱肿瘤切除术治疗非肌层浸润性膀胱癌的效果对比及对患者生活质量的影响[J]. 微创泌尿外科杂志, 2020, 9(1): 39-43.
BAI Bing, MU Jianjun, WANG Ling, GAO Jianyong, ZHEN Xiaomin, LEI Ge. Efficacy of two transurethral cystectomies for superficial bladder cancer and influence on urination function and life quality. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(1): 39-43.
[1] SIEGEL RL, MILLER KD, JEMAL A.Cancer statistics, 2017. CA Cancer J Clin, 2017,67(1):7-30. [2] 白恒舟,乔保平.比较吡柔比星和丝裂霉素C在膀胱癌电切术后膀胱灌注化疗安全性与疗效的Meta分析.临床泌尿外科杂志,2019,34(10):764-769. [3] BABJUK M, BÖHLE A, BURGER M, et al. EAU guidelines on Non-Muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol, 2017,71(3):447-461. [4] 刘杰,崔伟,车梓,等.经尿道膀胱肿瘤电切术治疗肌层浸润性膀胱癌的临床疗效.山东大学学报(医学版),2018,56(7):81-85. [5] 王志,申凯,王耀东.经尿道膀胱肿瘤钬激光切除术及经尿道膀胱肿瘤电切术治疗非肌层浸润膀胱癌临床疗效观察.创伤与急危重病医学,2018,6(4):208-210. [6] 张金刚,周健,马国忠.经尿道钬激光解剖性剜除术治疗表浅性膀胱肿瘤的临床疗效.中国现代医生,2018,56(19):51-53. [7] 黄健,梁朝朝,周利群,等.膀胱癌诊断治疗指南.北京:人民卫生出版社,2014:37-38. [8] EL-SIDDIG AA, ALBASRI AM, HUSSAINY AS, et al.Urinary bladder cancer in adults: a histopathological experience from Madinah, Saudi Arabia. J Pak Med Assoc, 2017,67(1):83-86. [9] 雷超,廖凯,董文瑞.经尿道钬激光膀胱肿瘤切除术与电切术对非肌层浸润性膀胱癌的疗效对比.实用癌症杂志,2019,34(2):296-299. [10] 贺金标,常琴,母健君.三种不同微创手术联合化疗治疗肌层浸润性膀胱癌的疗效及安全性分析.实用医院临床杂志,2019,16(2):51-54. [11] 白志鹏,唐以众.TURBT联合表柔比星与羟喜树碱膀胱灌注对非肌层侵润性膀胱癌患者术后复发率及生活质量的影响.解放军医药杂志,2019,31(4):40-43. [12] 张国平,雷弋,王岭,等.吉西他滨膀胱灌注治疗非肌层浸润性膀胱癌的疗效及安全性分析.四川医学,2018,39(11):1246-1249. [13] 刘一帆,徐桂彬,何永忠,等.经尿道钬激光切除术治疗非肌层浸润性膀胱肿瘤的疗效分析.现代泌尿生殖肿瘤杂志,2018,10(1):22-24. [14] HAN S, DONG K, SHEN MJ, et al.Observation and mechanism study of bladder wound healing after transurethral Holmium laser resection of bladder tumor. Lasers Med Sci, 2019,34(6):1217-1227. [15] RIVERO GÁ, FERNÁNDEZ APARICIO T, BARCELÓ BI, et al. Outpatient Holmium laser fulguration: A safe procedure for treatment of recurrence of nonmuscle invasive bladder cancer. Actas Urol Esp, 2018,42(5):309-315. [16] 陈先全. 膀胱癌患者miR-149表达与临床特征及预后的关联性.中国慢性病预防与控制,2019,27(5):344-348. [17] 张进,张婉蓉,高飞,等.等离子体电切术与电汽化术治疗老年膀胱癌的疗效对比.实用癌症杂志,2017,32(10):1706-1709.