经尿道针状电极精准切除治疗非肌层浸润性膀胱癌的临床疗效
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摘要
目的比较经尿道针状电极精准切除(ATUNER)与传统经尿道膀胱肿瘤切除(TURBT)治疗非肌层浸润性膀胱癌(NMIBC)的临床疗效及安全性。方法将100例NMIBC患者随机分为试验组(52例,ATUNER治疗)和对照组(48例,TURBT治疗)。比较两组的围手术期情况。结果试验组术中出血量及术后膀胱冲洗时间均明显优于对照组,手术时间长于对照组(P<0.05)。试验组闭孔神经反射发生率及复发率均明显低于对照组(P<0.05)。结论与TURBT比较,ATUNER在NMIBC的治疗中,虽需较长的手术时间,但治疗效果更显著,安全性更高,值得推广应用。
Objective To compare the clinical efficacy and safety of accurate transurethral needle-electrode resection(ATUNER) and conventional transurethral resection of bladder tumor(TURBT) in the treatment of non-muscularis invasive bladder cancer(NMIBC). Methods A total of 100 patients with NMIBC were randomly divided into experimental group(52 cases, ATUNER treatment) and control group(48 cases, TURBT treatment). The conditions of perioperative period of the two groups were compared. Results The intraoperative blood loss and postoperative bladder irrigation time in the experimental group were significantly better than those in the control group, the operation time was longer than that in the control group(P<0.05). The incidence of obturator nerve reflex and recurrence rate in the experimental group were significantly lower than those in the control group(P<0.05). Conclusion Compared with TURBT, ATUNER in NMIBC has longer operation time, but the treatment effect of which is more significant, with higher safety. It is worthy of popularization and application.
Objective To compare the clinical efficacy and safety of accurate transurethral needle-electrode resection(ATUNER) and conventional transurethral resection of bladder tumor(TURBT) in the treatment of non-muscularis invasive bladder cancer(NMIBC). Methods A total of 100 patients with NMIBC were randomly divided into experimental group(52 cases, ATUNER treatment) and control group(48 cases, TURBT treatment). The conditions of perioperative period of the two groups were compared. Results The intraoperative blood loss and postoperative bladder irrigation time in the experimental group were significantly better than those in the control group, the operation time was longer than that in the control group(P<0.05). The incidence of obturator nerve reflex and recurrence rate in the experimental group were significantly lower than those in the control group(P<0.05). Conclusion Compared with TURBT, ATUNER in NMIBC has longer operation time, but the treatment effect of which is more significant, with higher safety. It is worthy of popularization and application.
引文
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[10]薛庆.经尿道直出绿激光膀胱肿瘤剜除术在非肌层浸润性膀胱癌患者治疗中的有效性和安全性[J].四川医学,2017,38(11):1278-1281.
[11]程永毅,李晶,屈卫星,等.经尿道内镜黏膜下剥离术治疗非肌层浸润性膀胱肿瘤82例疗效分析[J].现代肿瘤医学,2016,24(20):3249-3252.
[12]张翼飞,梁朝朝,施浩强,等.整块剜除术治疗非肌层浸润性膀胱肿瘤[J].中华腔镜泌尿外科杂志:电子版,2016,10(6):11-14.
[13]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)[J].微创泌尿外科杂志,2013,2(6):396-398.
[14] ENGILBERTSSON H, AALTONEN KE, BJ O咬RNSSON S, et al.Transurethral bladder tumor resection can cause seeding of cancer cells into the bloodstream[J].J Urol,2015,193(1):53-57.
[15]李建昌,张凌君,孙圣坤,等.针状电极膀胱黏膜剥脱治疗输尿管口旁浅表性膀胱肿瘤5例报告[J].微创泌尿外科杂志,2014,3(3):171-174.
[2] HAN KS,JOUNG JY,CHO KS,et al.Results of repeated transurethral resection for a second opinion in patients referred for nonmuscle invasive bladder cancer:the referral cancer center experience and review of the literature[J].J Endourol,2008,22(12):2699-2704.
[3] DIVRIK R T,S AHIN AF,YILDIRIM U,et al.Impact of routine second transurethral resection on the long-term outcome of patients with newly diagnosed pT1 urothelial carcinoma with respect to recurrence, progression rate, and disease-specific survival:a prospective randomised clinical trial[J].Eur Urol,2010,58(2):185-190.
[4] MUTO G,COLLURA D,GIACOBBE A,et al.Thulium:yttrium-aluminumgarnet laser for en bloc resection of bladder cancer:clinical and histopathologic advantages[J].Urology,2014, 83(4):851-855.
[5] KRAMER MW,WOLTERS M,ABDELKAWI IF,et al.Transurethral en bloc resection of non-muscle invasive bladder cancer. What is the state of the art[J].Urologe A,2012,51(6):798-804.
[6]门群利,李涛,罗晓辉,等.经尿道等离子针状电极剜除术治疗非肌层浸润性膀胱肿瘤的临床分析[J].现代泌尿外科杂志,2017,22(5):365-367,372.
[7] KRAMER MW,BACH T,WOLTERS M,et al.Current evidence for transurethral laser therapy of non-muscle invasive bladder cancer[J].World J Urol,2011,29(4):433-442.
[8] TEKGU咬L ZT,DIVRIK RT,TURAN M,et al.Impact of obturator nerve block on the short-term recurrence of superficial bladder tumors on the lateral wall[J].Urol J,2014,11(1):1248-1252.
[9] HE D,FAN J,WU K,et al.Novel green-light KTP laser en bloc enucleation for nonmuscle-invasive bladder cancer:technique and initial clinical experience[J].J Endourol,2014,28(8):975-979.
[10]薛庆.经尿道直出绿激光膀胱肿瘤剜除术在非肌层浸润性膀胱癌患者治疗中的有效性和安全性[J].四川医学,2017,38(11):1278-1281.
[11]程永毅,李晶,屈卫星,等.经尿道内镜黏膜下剥离术治疗非肌层浸润性膀胱肿瘤82例疗效分析[J].现代肿瘤医学,2016,24(20):3249-3252.
[12]张翼飞,梁朝朝,施浩强,等.整块剜除术治疗非肌层浸润性膀胱肿瘤[J].中华腔镜泌尿外科杂志:电子版,2016,10(6):11-14.
[13]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)[J].微创泌尿外科杂志,2013,2(6):396-398.
[14] ENGILBERTSSON H, AALTONEN KE, BJ O咬RNSSON S, et al.Transurethral bladder tumor resection can cause seeding of cancer cells into the bloodstream[J].J Urol,2015,193(1):53-57.
[15]李建昌,张凌君,孙圣坤,等.针状电极膀胱黏膜剥脱治疗输尿管口旁浅表性膀胱肿瘤5例报告[J].微创泌尿外科杂志,2014,3(3):171-174.