2 μm激光、钬激光和经尿道膀胱肿瘤切除术治疗非肌层浸润性膀胱癌的比较研究
| 作者: |
1,2胡洋洋,
2牛晓振,
2王光春,
2黄建华,
2刘敏,
1,2彭波
1 南京医科大学第一临床学院，南京 210000 2 同济大学附属第十人民医院泌尿外科，上海 200072 |
| 通讯: |
彭波
Email: 512424474@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2016.04.019 |
摘要
目的：比较2 μm激光、钬激光与经尿道膀胱肿瘤切除术(transurethral resection of the bladder tumor，TURBT)治疗非肌层浸润性膀胱癌(non-muscle invasive bladder cancer，NMIBC)的有效性和安全性。方法：2011年6月至2013年6月期间，210例初诊为NMIBC患者被随机分到2 μm激光手术组(n=70)、钬激光手术组(n=70)和TURBT手术组(n=70)，记录手术时间、相关并发症、术后膀胱冲洗情况、留置导尿时间、住院时间。术后随访2年，定期行表柔比星膀胱灌注化疗和膀胱镜检查，记录膀胱肿瘤复发情况。结果：所有患者均顺利接受相应手术，2 μm激光组、钬激光组和TURBT组的平均手术时间和输血率无统计学差异(P>0.05)，TURBT组术中闭孔神经反射和膀胱穿孔发生率、术后需要膀胱冲洗病例、留置导尿时间、住院时间均高于2 μm激光组与钬激光组，差异有统计学差异(P<0.05)，且2 μm激光组与钬激光组之间比较无明显差异。术后两年的随访研究中，共有24名患者失访，三组患者肿瘤复发率无统计学差异(P>0.05)。结论：2 μm激光和钬激光在治疗NMIBC上优于传统的TURBT，2 μm激光与钬激光两者之间临床疗效比较无明显差异。且TURBT、2 μm激光和钬激光在术后肿瘤复发方面并无差异，下一步需要更多的病例数和更长的随访时间来验证本研究结果。
关键词：
膀胱肿瘤
2 μm激光
钬激光
经尿道膀胱肿瘤切除术
Comparative study of 2 μm laser, holmium laser and transurethral resection for non-muscle invasive bladder cancer
CorrespondingAuthor: PENG Bo Email: 512424474@qq.com
DOI: 10.3978/j.issn.2095-6959.2016.04.019
Abstract
Objective：To compare the efficacy and safety of 2μm laser, holmium laser and transurethral resection of bladder tumor (TURBT) for the treatment of non-muscle invasive bladder cancer (NMIBC).
Methods: From June 2011 to June 2013, 210 patients newly diagnosed primary NMIBC were divided into conventional TURBT group (n=70), holmium laser group (n=70) and 2μm laser group (n=70) randomly. Operative time, complications, postoperative bladder irrigation, catheterization time, hospitalization time were documented. A 2-year follow-up study was performed postoperatively, intravesical chemotherapy with epirubicin and cystoscopy were conducted simultaneously. Tumor recurrence rate was calculated and compared .
Results: All patients had received corresponding operations successfully. There was no statistically difference among the three groups for the mean operative time and incidence of blood transfusion (P>0.05). The incidences of obturator nerve reflex and bladder perforation, postoperative bladder irrigation, catheterization time, hospitalization time were significantly higher in TURBT group than in 2μm laser and holmium laser group, while there was no significant difference between 2μm laser group and holmium laser group. During the 2-year follow-up study postoperatively, 24 patients lost to follow-up, there was no significant difference in tumor recurrence rate among the three groups.
Conclusion: The use of 2μm laser and holmium laser in the management of NMIBC were superior to conventional TURBT, while there was no significant difference between 2μm laser and holmium laser in clinical efficacy. There were no differences in tumor recurrence rate and survival rate without tumor recurrence among the three groups. A longer follow-up period and larger numbers of patients are necessary to demonstrate the present results in the future.
Methods: From June 2011 to June 2013, 210 patients newly diagnosed primary NMIBC were divided into conventional TURBT group (n=70), holmium laser group (n=70) and 2μm laser group (n=70) randomly. Operative time, complications, postoperative bladder irrigation, catheterization time, hospitalization time were documented. A 2-year follow-up study was performed postoperatively, intravesical chemotherapy with epirubicin and cystoscopy were conducted simultaneously. Tumor recurrence rate was calculated and compared .
Results: All patients had received corresponding operations successfully. There was no statistically difference among the three groups for the mean operative time and incidence of blood transfusion (P>0.05). The incidences of obturator nerve reflex and bladder perforation, postoperative bladder irrigation, catheterization time, hospitalization time were significantly higher in TURBT group than in 2μm laser and holmium laser group, while there was no significant difference between 2μm laser group and holmium laser group. During the 2-year follow-up study postoperatively, 24 patients lost to follow-up, there was no significant difference in tumor recurrence rate among the three groups.
Conclusion: The use of 2μm laser and holmium laser in the management of NMIBC were superior to conventional TURBT, while there was no significant difference between 2μm laser and holmium laser in clinical efficacy. There were no differences in tumor recurrence rate and survival rate without tumor recurrence among the three groups. A longer follow-up period and larger numbers of patients are necessary to demonstrate the present results in the future.