摘要
目的:评价2μm激光治疗非肌层浸润性膀胱肿瘤(NMIBT)的疗效及其与经尿道膀胱肿瘤电切术(TURBt)治疗的优劣。方法:采用TURBt治疗NMIBT患者33例(TURBt组),采用2μm激光治疗NMIBT患者52例(2μm激光组)。其中56例为初发膀胱肿瘤患者;24例为多发肿瘤患者;22例患者至少一处肿瘤直径超过2.5 cm。两组术后常规膀胱灌洗化疗,并每3个月作膀胱镜检查。比较两组手术时间、术后住院时间、并发症及术后肿瘤复发率。结果:85例患者平均手术时间(26.59±11.63)(5～75)min,其中2μm激光组手术时间(24.33±10.10)min,TURBt组(30.15±13.08)min(P=0.034)。TURBt组1例术中膀胱穿孔,2例术后出血;2μm激光组未出现围手术期并发症。术后留院时间2μm组为(3.19±0.93)天,TURBt组为(3.83±1.82)天(P=0.067)。术后3个月TURBt组中1例出现肾积水,2μm激光组中1例出现肾输尿管反流,1例尿道外口狭窄。随访(15.45±8.08)(3～39)个月,21例肿瘤复发,其中19例肿瘤复发于术后12月内。2μm激光组术后3、6、9、12个月分别有0、4、5、1例复发,1年肿瘤复发率为19.23%;TURBt组术后3、6、9、12个月分别有1、2、4、2例肿瘤复发,复发率为27.27%。2μm激光组肿瘤复发率及并发症发生率与TURBt组无显著差别。结论:2μm激光与传统TURBt相比,可有效提高手术安全性及患者手术耐受力,明显缩短手术时间,减少患者术后留院时间,但对NMIBT的疗效并无明显优势,仍有一定局限性。
Objective：To evaluate the advantages and disadvantages of 2 μm continuous wave thulium laser for the treatment of non-muscle-invasive bladder tumor （NMIBT） by comparing the results of transurethral resection （TURBO. Methods：We reviewed 85 patients with NMIBT who treated in our hospital, 33 cases were treated by TURBt, and 52 patients were treated by 2 μm continuous wave thulium laser. Of 56 cases whose bladder tumor were first been detected, 24 cases were multiple tumor. Of 22 cases the tumor diameter was greater 2.5 cm. After surgery , every patient accepted regular intravesical chemical drug instillation, and repeated cystoscope examination every 3 months. The recurrence-free survival rate of two groupsoperative time, postoperatiye hospital stay, complications and recurrence rate were also been compared. Results：The average operation time of overall patients was 26.59±11.63 min （5-75）min, with 24.33±10. 10 min in 2 μm thulium laser group and 30. 15±13.08 min in TURBt group respectively （P=0. 034）. No intraoperative complication was reported in 2 μm thulium laser group while vesical perforation in 1 patient was found in TURBt group. Postoperative complications in 2 patients were found in 2 μm thulium laser group while 3 occurred in TURBt group, The overall complication rate between two groups was no statistics difference （P= 0. 126）. The postoperative hospitalization time of each group was 3.19± 0. 93 days in 2 μm thulium laser group and 3.83±1.82 days in TURBt group （P=0. 067）. 21 patients tumor recurred during 15.45±8.08 months followup （range 3-39 months）. In 2 μm thulium laser group, 0,4,5,1 recurrence cases were found in 3,6,9,12 moths, one year recurrence rate was 19.23% postoperatively, while in TURBt group, 1,2,4,2 recurrence cases were detected respectively, recurrence rate was 27.27%. No statistics difference was found by comparing with the recurrence free rate of two groups （P = 0.341）. Conclusions：Comparing with traditional TURBt, treating NMIBT with
出处
《临床泌尿外科杂志》
北大核心
2010年第6期408-411,共4页
Journal of Clinical Urology
