老年非肌层浸润性膀胱癌合并前列腺增生症患者行同期经尿道电切术的临床效果
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摘要
目的探讨老年非肌层浸润性膀胱癌(NMIBC)合并前列腺增生症(BPH)患者行同期经尿道电切术的临床效果。方法回顾性分析78例老年NMIBC合并BPH患者的临床资料,根据患者的治疗方式将其分为同期组(n=43)和对照组(n=35)。同期组采用经尿道膀胱肿瘤电切术(TURBT)+经尿道前列腺电切除术(TURP)治疗,对照组仅实施TURBT治疗。比较两组患者的临床效果。结果同期组患者的手术时间、留置尿管时间及住院时间均长于对照组,且术中出血量多于对照组(P<0.05)。出院时及术后1年,同期组患者的IPSS评分、PVR及Qmax均优于对照组(P<0.05)。术后2年,两组患者的肿瘤复发率比较,差异无统计学意义(P>0.05);同期组患者的尿道狭窄发生率低于对照组(P<0.05)。结论对老年NMIBC合并BPH患者实施同期经尿道电切术是可行的,尽管手术时间、出血量等方面不占优势,但远期膀胱功能、排尿情况的改善更明显,且可明显降低尿道狭窄发生率。
Objective To investigate the clinical effect of concurrent transurethral resection in elderly patients with non-muscle invasive bladder cancer(NMIBC) and benign prostatic hyperplasia(BPH). Methods The clinical data of 78 elderlypatients with NMIBC combined with BPH were retrospectively analyzed. According to the treatment methods, the patientswere divided into contemporaneous group(n =43) and control group(n =35). The contemporaneous group was giventransurethral resection of bladder tumor(TURBT) and transurethral resection of prostate(TURP), while the control groupwas given TURP. The clinical effects in both groups were compared. Results The operation time, indwelling catheter timeand hospitalization time of the contemporaneous group were longer than those of the control group, and the intraoperativebleeding volume was more than that of the control group(P<0.05). At discharge and 1 year after operation, the IPSS score,PVR and Qmax of the contemporaneous group were better than those of the control group(P <0.05). Two years afteroperation, there was no significant difference in recurrence rate between the two groups(P>0.05); the incidence of urethralstricture in the contemporaneous group was lower than that in the control group(P <0.05). Conclusion It is feasible toperform concurrent transurethral resection for elderly patients with NMIBC and BPH. Although the operation time andbleeding volume are not dominant, the improvement of bladder function and urination in the long term is more obvious, andthe incidence of urethral stricture can be significantly reduced.
Objective To investigate the clinical effect of concurrent transurethral resection in elderly patients with non-muscle invasive bladder cancer(NMIBC) and benign prostatic hyperplasia(BPH). Methods The clinical data of 78 elderlypatients with NMIBC combined with BPH were retrospectively analyzed. According to the treatment methods, the patientswere divided into contemporaneous group(n =43) and control group(n =35). The contemporaneous group was giventransurethral resection of bladder tumor(TURBT) and transurethral resection of prostate(TURP), while the control groupwas given TURP. The clinical effects in both groups were compared. Results The operation time, indwelling catheter timeand hospitalization time of the contemporaneous group were longer than those of the control group, and the intraoperativebleeding volume was more than that of the control group(P<0.05). At discharge and 1 year after operation, the IPSS score,PVR and Qmax of the contemporaneous group were better than those of the control group(P <0.05). Two years afteroperation, there was no significant difference in recurrence rate between the two groups(P>0.05); the incidence of urethralstricture in the contemporaneous group was lower than that in the control group(P <0.05). Conclusion It is feasible toperform concurrent transurethral resection for elderly patients with NMIBC and BPH. Although the operation time andbleeding volume are not dominant, the improvement of bladder function and urination in the long term is more obvious, andthe incidence of urethral stricture can be significantly reduced.
引文
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[2]黄一珂.非肌层浸润性膀胱癌诊治现状及进展[J].西南军医2016,18(1):80-83.
[3]崔洪雨,杨俊,孔祥斌,等.经尿道同期手术治疗非肌层浸润性膀胱癌及前列腺增生对膀胱癌复发影响的Meta分析[J].现代泌尿外科杂志,2015,20(12):889-894.
[4]范晋海,曹建伟.非肌层浸润性膀胱癌合并良性前列腺增生患者可同期行经尿道膀胱肿瘤电切术+经尿道前列腺电切术[J].现代泌尿外科杂志,2014,19(8):547-549.
[5]徐涛.大数据时代的小数据思维-试评能否同时进行经尿道膀胱肿瘤电切术+经尿道前列腺电切术[J].现代泌尿外科杂志,2014,19(8):551-552.
[6]赵华,周锦波.新型可视前列腺症状评分在前列腺增生症状评估中的临床研究[C]//2016全国慢性病诊疗论坛,2016.
[7]NARGUND VH,TANABALAN CK,KABIR MN.Management of nonmuscle-invasive(superficial)bladder cancer[J].Semin Oncol,2012,39(5):559-572.
[8]舒则荣,武良,关喜彬,等.非肌层浸润性膀胱癌合并前列腺增生诊治体会[J].中国医刊,2012,47(12):62-63.