摘要
目的探讨使用钬激光沿膀胱深肌层整体剜除肿瘤在膀胱尿路上皮癌手术治疗中的安全性及可行性。方法选取符合要求的膀胱癌患者50例随机分为试验组(n=31)与对照组(n=29),试验组行经尿道膀胱肿瘤钬激光剜除术,术中应用钬激光沿膀胱深肌层整体剜除肿瘤,对照组行经尿道膀胱肿瘤钬激光汽化切割或沿膀胱黏膜下层或浅肌层剜除肿瘤。记录手术时间、住院时间、手术出血量、是否膀胱穿孔、是否尿外渗、术后病理、复发时间、生活质量评分及患者满意度。通过对比结果得出结论。结果所有患者顺利完成手术,2组手术时间、住院时间、膀胱穿孔率、膀胱尿外渗几率、生活质量评分、满意度评价比较,差异均无统计学意义(P>0.05)。试验组出血量明显少于对照组,基底阳性率复发率低于对照组,差异有统计学意义(P<0.05)。结论经尿道膀胱肿瘤钬激光深肌层整体剜除术在膀胱尿路上皮癌治疗中安全有效,能较为彻底切除肿瘤,延缓疾病进展。
Objective To investigate the safety and feasibility of holmium laser enucleation of bladder along the deep muscular layer in surgical treatment of bladder urothelial carcinoma.Methods A total of 50 patients with bladder carcinoma were randomly divided into experimental group(n=31)and control group(n=29).The patients in experimental group were treated by transurethral holmium laser whole enucleation along the deep muscle layer of bladder during operation,howeve,the patients in control group were treated by transurethral holmium laser vaporization or enucleation along the submucosa or superficial muscles of bladder.The operation time,bleeding volume,hospitalization time,bladder perforation rate,pathological staus and recurrence time,and life quality score as well as patient’s satisfaction degree were observed and compared between the two groups.Results All the patients underwent successful operation.There were no significant differences in the operation time,hospitalization time,bladder perforation rate,bladder urinary extravasation rate,life quality score,and satisfaction evaluation between the two groups(P>0.05).The bleeding volume in experimental group was significantly less than that in control group,and the recurrence rate of basal positive rate was in experimental group was significantly lower than that in control group(P<0.05).Conclusion The transurethral holmium laser whole enucleation in treatment bladder urothelial carcinoma is safe and effective,which can remove the tumors thoroughly and delay the progress of the disease.
作者
汪鑫
刘文军
耿玉山
齐进春
张明
王东彬
WANG Xin;LIU Wenjun;GENG Yushan(Department of Urology,The Second Hospital of Hebei Medical University,Hebei, Shijiazhuang 050000,China)
出处
《河北医药》
CAS
2019年第24期3726-3729,3733,共5页
Hebei Medical Journal
关键词
膀胱肿瘤剜除术
钬激光
膀胱深肌层
膀胱尿路上皮癌
enucleation of bladder tumors
holmium laser
deep muscular layer of bladder
bladder urothelial carcinoma
