等离子电切术治疗非肌层浸润性膀胱癌的效果及生存情况
| 作者: |
1陈巍巍,
1陈建华
1 如皋市中医院泌尿外科，江苏 如皋 226500 |
| 通讯: |
陈建华
Email: 570543360@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2023.222253 |
摘要
目的：比较两种等离子电切术治疗非肌层浸润性膀胱癌的效果及生存情况。方法：回顾性纳入2019年1月至2020年9月于如皋市中医院就诊的63例非肌层浸润性膀胱癌患者，其中行经尿道等离子针状电极精准切除术(accurate transurethral needle-electrode resection，ATUNER)的患者入选ATUNER组(n=34)，行尿道等离子环状电极切除术治疗的患者入选对照组(n=29)。分析所有患者的围手术期资料、术后排尿功能、肿瘤标志物的水平变化及术后生存情况。结果：ATUNER组的手术用时显著短于对照组(P<0.05)，术中出血量显著少于对照组(P<0.05)。术后，ATUNER组的闭孔神经反射发生率显著低于对照组(P0.05)。与术前相比，术后两组患者的血管内皮生长因子(vascular endothelial growth factor，VEGF)、细胞角蛋白19片段(cytokeratin 19 fragment antigen 21-1，CYFRA21-1)、膀胱肿瘤抗原(bladder tumor antigen，BTA)、核基质蛋白22(nuclear matrix protein 22，NMP22)水平均显著下降(均P<0.05)，其中ATUNER组的VEGF、BTA、NMP22水平均显著低于对照组(P<0.05)。术后对照组的2年复发率显著高于ATUNER组(P<0.05)。对照组的无复发生存期显著低于ATUNER(P=0.015)。结论：ATUNER治疗非肌层浸润性膀胱癌效果较好，手术用时短，术后并发症发生率和复发率较低，患者无复发生存期较长，值得临床推广应用。
关键词：
等离子电切术；非肌层浸润性膀胱癌；等离子针状电极
Efficacy and survival of plasma electrocision in the treatment of non-muscle invasive bladder cancer
CorrespondingAuthor: CHEN Jianhua Email: 570543360@qq.com
DOI: 10.3978/j.issn.2095-6959.2023.222253
Abstract
Objective: To compare the efficacy and survival of 2 plasma electrosurgery for non-muscle invasive bladder cancer.
Methods: A total of 63 patients with non-muscle invasive bladder cancer who were admitted to Rugao Hospital of Chinese Medicine from January 2019 to September 2020 were enrolled retrospectively. The patients underwent accurate transurethral needle-electrode excision (ATUNER) were assigned to the ATUNER group (n=34). The patients treated with urethral plasma ring electrode excision were assigned to the controd group (n=29). The perioperative data, postoperative urinary function, changes in tumor marker levels, and postoperative survival of all patients were analyzed.
Results: The operation time of the ATUNER group was significantly shorter than that of the control group (P<0.05), and the intraoperative blood loss was significantly less than that of the control group (P<0.05). After operation, the incidence of obturator nerve reflex in the ATUNER group was significantly lower than that in the control group (P0.05). Compared with before operation, the levels of vascular endothelial growth factor (VEGF), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), bladder tumor antigen (BTA), and nuclear matrix protein 22 (NMP22) in the 2 groups after operation were significantly decreased (all P<0.05), and the levels of VEGF, BTA, and NMP22 in the ATUNER group were significantly lower than those in the control group (all P<0.05). After the surgery, the 2-year recurrence rate in the control group was significantly higher than that in the ATUNER group (P<0.05). The recurrence-free survival of the control group was significantly lower than that of the ATUNER group (P=0.015).
Conclusion: ATUNER has good curative effect in the treatment of non-muscle invasive bladder cancer, with shorter operation time, lower postoperative complication rate and recurrence rate, and longer recurrence-free survival, which is worthy of clinical application.
Keywords：
transurethral plasma resection; non-muscular invasive bladder cancer; plasma needle electrode
Methods: A total of 63 patients with non-muscle invasive bladder cancer who were admitted to Rugao Hospital of Chinese Medicine from January 2019 to September 2020 were enrolled retrospectively. The patients underwent accurate transurethral needle-electrode excision (ATUNER) were assigned to the ATUNER group (n=34). The patients treated with urethral plasma ring electrode excision were assigned to the controd group (n=29). The perioperative data, postoperative urinary function, changes in tumor marker levels, and postoperative survival of all patients were analyzed.
Results: The operation time of the ATUNER group was significantly shorter than that of the control group (P<0.05), and the intraoperative blood loss was significantly less than that of the control group (P<0.05). After operation, the incidence of obturator nerve reflex in the ATUNER group was significantly lower than that in the control group (P0.05). Compared with before operation, the levels of vascular endothelial growth factor (VEGF), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), bladder tumor antigen (BTA), and nuclear matrix protein 22 (NMP22) in the 2 groups after operation were significantly decreased (all P<0.05), and the levels of VEGF, BTA, and NMP22 in the ATUNER group were significantly lower than those in the control group (all P<0.05). After the surgery, the 2-year recurrence rate in the control group was significantly higher than that in the ATUNER group (P<0.05). The recurrence-free survival of the control group was significantly lower than that of the ATUNER group (P=0.015).
Conclusion: ATUNER has good curative effect in the treatment of non-muscle invasive bladder cancer, with shorter operation time, lower postoperative complication rate and recurrence rate, and longer recurrence-free survival, which is worthy of clinical application.