[1]陶伟 徐明 朱进 刘晓龙 臧亚晨 孙传洋 阳东荣 薛波新*.980 nm红激光经尿道膀胱肿瘤整块切除与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的疗效比较[J].中国微创外科杂志,2021,01(12):1086-1090.
　Tao Wei,Xu Ming,Zhu Jin,et al.Comparison of Curative Effect Between 980 nm Red Laser Transurethral Enbloc Resection and Transurethral Resection for Nonmuscle Invasive Bladder Cancer[J].Chinese Journal of Minimally Invasive Surgery,2021,01(12):1086-1090.
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980 nm红激光经尿道膀胱肿瘤整块切除与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的疗效比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年12期
页码:
1086-1090
栏目:
临床研究
出版日期:
2021-12-25

文章信息/Info

Title:
Comparison of Curative Effect Between 980 nm Red Laser Transurethral Enbloc Resection and Transurethral Resection for Nonmuscle Invasive Bladder Cancer
作者:
陶伟 徐明 朱进 刘晓龙 臧亚晨 孙传洋 阳东荣 薛波新*
(苏州大学附属第二医院泌尿外科，苏州215004)
Author(s):
Tao Wei;  Xu Ming;  Zhu Jin;  et al.
Department of Urology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
关键词:
980 nm红激光; 整块切除; 膀胱肿瘤
Keywords:
980 nm red laser; Enbloc resection; Bladder tumor
文献标志码:
A
摘要:
目的比较980 nm红激光经尿道膀胱肿瘤整块切除与经尿道膀胱肿瘤电切术(transuretheral resection of bladder tumor，TURBt)治疗非肌层浸润性膀胱癌(nonmuscle invasive bladder cancer，NMIBC)的安全性和有效性。方法回顾性分析2017年4月~2019年9月我院144例NMIBC的临床资料，体内有金属植入物者行980 nm红激光经尿道膀胱肿瘤整块切除(980 nm红激光组，n=68)，其余行TURBt(TURBt组，n=76)，术后均接受规范性膀胱灌注治疗。比较2组手术时间、膀胱冲洗时间、保留导尿时间、术后住院时间和闭孔神经反射、膀胱穿孔等围手术期并发症发生情况。结果2组均顺利完成手术，其中980 nm红激光组无一例中转开放手术，TURBt组2例中转开放手术。980 nm红激光组手术时间(21.6±38)min，与TURBt组(22.3±3.2)min差异无统计学意义(t=1.200，P=0.195)。980 nm红激光组膀胱冲洗例数及时间、导尿管留置时间、住院时间均明显少于/短于TURBt组(P<0.05)。TURBt组分别有8、5例发生闭孔神经反射及膀胱穿孔，980 nm红激光组无一例发生闭孔神经反射及膀胱穿孔，2组差异有统计学意义(P=0.005，P=0.038)。术后病理证实均为非肌层浸润性尿路上皮癌。2组患者术后随访12个月，980 nm红激光组复发2例，TURBt组复发4例，2组肿瘤复发率无统计学差异(χ2=0.078，P=0.081)。结论980 nm红激光整块切除法治疗NMIBC安全、有效。与TURBt相比，980 nm红激光围手术期并发症少，可获得精确病理分期，肿瘤复发率相似。
Abstract:
ObjectiveTo compare the safety and efficacy of 980 nm red laser transurethral enbloc resection of bladder tumor and transurethral resection of bladder tumor (TURBt) in the treatment of nonmuscle invasive bladder cancer (NMIBC).MethodsThe clinical information of 144 patients with NMIBC from April 2017 to September 2019 were analyzed retrospectively. Patients with metal implants underwent 980 nm laser transurethral resection (980 nm red laser group, n=68), and the rest underwent TURBt (TURBt group, n=76). All the patients received standard bladder perfusion therapy after operation. The operation time, bladder irrigation time, catheterization time, hospitalization time, and perioperative complications such as obturator nerve reflex and bladder perforation were recorded and analyzed.ResultsAll the patients underwent the operation successfully. There was no conversion to open surgery in the 980 nm red laser group and 2 cases in the TURBt group. The operation time of the 980 nm red laser group was (21.6±3.8) min, which was not significantly different from that of the TURBt group ［(22.3±3.2) min, t=1.200, P=0.195］. The number and time of bladder irrigation, catheter indwelling time and hospitalization time in the 980 nm red laser group were significantly lower/shorter than those in the TURBt group (P<0.05). The obturator nerve reflex and bladder perforation occurred in 8 cases and 5 cases respectively in the TURBt group, whereas none in the 980 nm red laser group, with significant differences between the two groups (P=0.005, P=0.038). Postoperative pathology confirmed nonmyometrial invasive urothelial carcinoma. The patients in the two groups were followed up for 12 months. There were 2 cases of recurrence in the 980 nm red laser group and 4 cases in the TURBt group. There was no significant difference in the tumor recurrence rate between the two groups (χ2=0.078, P=0.081).ConclusionsUse of 980 nm laser enbloc resection is a safe and effective treatment for NMIBC. As compared with TURBt, 980 nm laser has fewer perioperative complications and accurate pathological staging, and the tumor recurrence rate is similar.

参考文献/References:

[1]Sanli O, Dobruch J, Knowles MA, et al. Bladder cancer. Nat Rev Dis Primers,2017,3:17022.
[2]Lazica DA, Roth S, Brandt AS, et al. Second transurethral resection after Ta highgrade bladder tumor: a 4.5year period at a single university center. Urol Int,2014,92(2):131-135.
[3]Kramer MW, Altieri V, Hurle R, et al. Current evidence of transurethral enbloc resection of non muscle invasive bladder cancer. Eur Urol Focus,2017,3(6):567-576.
[4]Herrmann TR, Liatsikos EN, Nagele U, et al．EAU guidelines on laser technologies. Eur Urol,2012,61(4):783-795.
[5]Babjuk M, Oosterlinck W, Sylvester R, et al. EAU Guidelines on nonmuscleinvasive urothelial carcinoma of the bladder, the 2011 update. Eur Urol,2011,59(6):997-1008.
[6]Stenzl A, Cowan NC, De Santis M, et al. Treatment of muscle invasive and metastatic bladder cancer.Update of the EAU Guidelines. Eur Urol,2011,59(6):1009-1018.
[7]Kramer MW, Bach T, Wolters M, et al. Current evidence for transurethral laser therapy of nonmuscle invasive bladder cancer. World J Urol,2011,29(4):433-442.
[8]Daneshmand S. The value of extended transurethral resection of bladder tumour (TURBT) in the treatment of bladder cancer. BJU Int,2012,110(2 Pt 2):E80.
[9]Brausi M, Witjes JA, Lamm D, et al. A review of current guidelines and best practice recommendations for the management of non muscle invasive bladder cancer by the International Bladder Cancer Group. J Urol,2011,186(6):2158-2167.
[10]Wu YP, Lin TT, Chen SH,et al. Comparison of the efficacy and feasibility of enbloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor:A metaanalysis. Medicine (Baltimore),2016,95(45):e5372.
[11]Kramer MW, Abdelkawi IF, Wolters M, et al. Current evidence for transurethral en bloc resection of nonmuscleinvasive bladder cancer. Minim Invasive Ther Allied Technol,2014,23(4):206-213.
[12]Schraml J, Silva JDC, Babjuk M. Current concept of transurethral resection of bladder cancer: from retransurethral resection of bladder cancer to enbloc resection. Curr Opin Urol,2018,28(6):591-597.
[13]Ukai R, Kawashita E, Ikeda H. A new technique for transurethral resection of superficial bladder tumor in 1 piece. J Urol,2000,163(3):878-879.
[14]刘余庆,卢剑,肖春雷,等.2 μm连续波激光与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.中国微创外科杂志，2013,13(1):23-28.
[15]李佳朔,尚攀峰.经尿道膀胱肿瘤整体剜除术治疗非肌层浸润性膀胱癌的研究进展.中国微创外科杂志,2020,20(9):848-852.
[16]孙浩洋,李明,李宝龙.经尿道红激光汽化切除非肌层浸润性膀胱癌30例疗效观察.现代泌尿生殖肿瘤杂志,2015,7(5):278-280.
[17]Kramer MW, Altieri V, Hurle R, et al. Current evidence of transurethral enbloc resection of nonmuscle invasive bladder cancer. Eur Urol Focus,2017,3(6):567-576.
[18]Migliari R, Buffardi A, Ghabin H. Thulium laser endoscopic en bloc enucleation of nonmuscle invasive bladder cancer. J Endourol,2015,29(11):1258-1262.
[19]Muto G, Collura D, Giacobbe A, et al. Thulium: yttriumaluminumgarnet laser for en bloc resection of bladder cancer:clinical and histopathologic advantages. Urology,2014,83(4):851-855.

备注/Memo

备注/Memo:
*通讯作者，Email：18994392817@163.com
更新日期/Last Update: 2022-04-07