首页|GL-EBR术对NMIBC患者复发和进展的影响

GL-EBR术对NMIBC患者复发和进展的影响

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目的 探讨经尿道膀胱肿瘤电切术(TURBT)与经尿道膀胱肿瘤绿激光整块剜除术(GL-EBR)对非肌层浸润膀胱癌(NMIBC)患者复发及进展的影响.方法 回顾性分析2018年1月至2020年7月于本院进行治疗的138例NMIBC患者的临床资料,其中77例患者行TURBT治疗(对照组),61例患者行GL-EBR治疗(观察组).对比两组患者的一般资料、术中相关指标、术后复发率以及术后并发症情况.同时,根据病理结果的肿瘤级别情况进一步将患者分为高级别TURBT组(A组,17例)、高级别GL-EBR组(B组,21例)、低级别TURBT组(C组,60例)、低级别GL-EBR组(D组,40例),对比不同肿瘤级别亚组之间的术中相关指标、术后复发率以及术后并发症发生率等.结果 两组患者的一般资料比较,差异无统计学意义(P>0.05),观察组与对照组的手术时间、膀胱穿孔例数比较,差异均无统计学意义(均P>0.05),观察组的术中出血量、闭孔神经反射例数少于对照组,术后复发率低于对照组,差异均有统计学意义(均P<0.05);观察组和对照组的术后并发症比较,差异无统计学意义(P>0.05).在不同肿瘤级别的亚组分析中,B组的术中出血量少于A组(P<0.05),B组的术后复发率明显低于A组,差异有统计学意义[38.1%(8/21)vs.76.5%(13/17),P<0.05].C组和D组的术中出血量,手术时间、术后并发症以及术后复发率比较,差异均无统计学意义(均P>0.05).结论 GL-EBR手术治疗NMIBC安全有效,术中出血量小,可降低术后复发率,特别是肿瘤级别较高的非肌层浸润性膀胱肿瘤.
Effect of transurethral green-light laser en bloc resection of bladder tumor on recurrence and progression of non-muscle invasive bladder cancer
Objective To investigate the effects of transurethral resection of bladder tumor(TURBT)and transurethral green-light laser en bloc resection(GL-EBR)on the recurrence and pro-gression of non-muscular invasive bladder cancer(NMIBC).Methods The clinical data of 138 pa-tients with NMIBC treated in our hospital from January 2018 to July 2020 were retrospectively ana-lyzed,including 77 patients who underwent TURBT surgery(control group)and 61 patients who un-derwent GL-EBR surgery(observation group).The general data,intraoperative indicators,postopera-tive recurrence rate and postoperative complications were compared between the two groups.Mean-while,according to the pathological results,the tumor grade was further divided into high grade TURBT group(group A,17 cases),high grade GL-EBR group(group B,21 cases),low grade TURBT group(group C,60 cases)and low grade GL-EBR group(group D,40 cases).The intraop-erative indexes,postoperative recurrence rate and postoperative complication rate were compared a-mong different tumor grade subgroups.Results The comparison of general data between the two groups showed no statistical significance(P>0.05),and the comparison of operation time and blad-der perforation between the observation group and the control group showed no statistical significance(all P>0.05).The intraoperative blood loss and obturator nerve reflex in the observation group were less than that in the control group,the postoperative recurrence rate was lower than that in the control group.The differences were statistically significant(all P<0.05).There was no significant difference in postoperative complications between the observation group and the control group(P>0.05).In the subgroup analysis of different tumor grades,the intraoperative blood loss in group B was significantly less than that in group A(P<0.05),and the postoperative recurrence rate in group B was significant-ly lower than that in group A,with statistical significance(P<0.05).There were no significant differences in intraoperative blood loss,operation time,postoperative complications and postoperative recurrence rate between group C and group D(all P>0.05).Conclusions GL-EBR is safe and ef-fective in the treatment of NMIBC,with a small amount of intraoperative blood loss,and can reduce the postoperative recurrence rate,especially for these with higher tumor grade.

Urinary Bladder NeoplasmsCystectomyGreen Laser Whole Block Enucleation of Bladder Tumors

雷晓航、王鸿渊、张建国

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河南科技大学临床医学院,河南科技大学第一附属医院泌尿外科,洛阳 471003

膀胱肿瘤 膀胱切除术 绿激光膀胱肿瘤整块剜除

2024

国际泌尿系统杂志
中华医学会,湖南省医学会

国际泌尿系统杂志

CSTPCD
影响因子:0.414
ISSN:1673-4416
年,卷(期):2024.44(1)
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