摘要
目的通过荟萃分析比较双极经尿道膀胱肿瘤电切术(bTURBT)与单极经尿道膀胱肿瘤切除术(mTURBT)的有效性和安全性。方法2019年5月在PubMed、Medline、Embase和Cochrane图书馆数据库检索,并用所得数据进行随机对照试验(RCTs)的配对荟萃分析。结果共有9个随机对照试验,1879名患者(889名mTURBT患者和990名bTURBT患者)被纳入本次荟萃分析。研究发现,在血红蛋白水平(WMD=-0.32,95%CI:-0.60^-0.04,P=0.027)和钠水平(WMD=-0.83,95%CI:-1.06^-0.60,P<0.001)方面,bTURBT优于mTURBT。2种术式在闭孔神经反射、膀胱穿孔、输血、血栓潴留、电切综合征、切除时间、置管时间、术后停留时间、无复发生存率等方面无显著性差异。然而,bTURBT为组织样本提供了明显较低的烧灼伪影(OR=0.32,95%CI:0.18~0.56,P<0.001)。结论单极和双极技术在疗效和安全性方面并没有显著的差异。但是bTURBT保留了更好的组织,这意味着在经尿道膀胱肿瘤切除术中热损伤率较低,能够为病理科医生提供更好的病理组织。
Objective To systematically compare the efficacy and safety of bipolar transurethral resection of bladder tumor(bTURBT)and monopolar transurethral resection of bladder tumor(mTURBT).Methods Relevant studies published before May 2019 were searched in PubMed,Medline,Embase and Cochrane.Pairwise Meta-analysis of randomized controlled trials(RCTs)was conducted to compare the efficacy and safety of bTURBT and mTURBT.Results A total of 9 RCTs with 1879 patients(889 mTURBT and 990 bTURBT patients)were included in the Meta-analysis.Our study found that bTURBT was superior to mTURBT in terms of hemoglobin level(WMD=-0.32,95%CI:-0.60--0.04,P=0.027)and sodium level(WMD=-0.83,95%CI:-1.06--0.60,P<0.001).There were no significant differences between the two techniques with respect to obturator nerve reflex,bladder perforation,blood transfusion,clot retention,transurethral resection(TUR)syndrome,resection time,catheterization time,postoperative hospital stay and recurrence-free survival rate.However,bTURBT provided tissue samples with significantly lower cautery artifact(OR=0.32,95%CI:0.18-0.56,P<0.001).Conclusion There are no significant differences in safety and efficacy between mTURBT and bTURBT,but bTURBT can preserve tissues better,which means less thermal damage rate and better tissues for pathologists.
作者
黎子瑞
陈吉祥
简钟宇
艾建忠
金熙
魏鑫
叶冬晖
李虹
王坤杰
LI Zi-rui;CHEN Ji-xiang;JIAN Zhong-yu;AI Jian-zhong;JIN Xi;WEI Xin;YE Dong-hui;LI Hong;WANG Kun-jie(Department of Urology,Institute of Urology,Laboratory of Reconstructive Urology,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《现代泌尿外科杂志》
CAS
2020年第6期505-509,523,共6页
Journal of Modern Urology
关键词
经尿道膀胱肿瘤切除术
荟萃分析
单极
双极
膀胱癌
transurethral resection of bladder tumor
Meta-analysis
monopolar
bipolar
bladder cancer
