| 二次等离子电切术在非肌层浸润性膀胱肿瘤中的应用 |
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| 引用本文： | 李立强,郭园园,岳晓娥,王成勇,李庆文,刘建民,刘贝贝.二次等离子电切术在非肌层浸润性膀胱肿瘤中的应用[J].中华全科医学,2020,18(10):1629-1632. |
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| 作者姓名： | 李立强 郭园园 岳晓娥 王成勇 李庆文 刘建民 刘贝贝 |
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| 作者单位： | 蚌埠医学院第一附属医院泌尿外科, 安徽 蚌埠 233004 |
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| 基金项目： | 安徽省自然科学青年基金(1808085QH279)国家自然科学基金青年科学基金(81702495)安徽省教育厅高校自然科学基金重点项目(KJ2019A0308) |
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| 摘 要： | 目的 讨论二次等离子电切术在非肌层浸润性膀胱肿瘤中的应用价值。 方法 回顾性分析2017年7月—2019年1月于蚌埠医学院第一附属医院泌尿外科行膀胱肿瘤等离子电切术的非肌层浸润性膀胱肿瘤患者113例。其中43例于首次等离子电切术后4~6周行二次电切术的患者为观察组,其余行单次等离子电切术患者70例为对照组。记录并分析以下临床资料,包括一般资料:性别、年龄、BMI、肿瘤大小、数目、术前分期、病理分级;手术相关情况:术后留置导尿时间、术中及术后相关并发症等;术后病理及预后资料:二次等离子电切病理阳性率、2组患者术后肌层浸润率及随访12个月后局部复发率等。 结果 2组患者一般资料和手术相关情况差异无统计学意义(均P>0.05);观察组3例患者(6.98%)二次等离子电切术后病理可见尿路上皮肿瘤细胞;观察组一次等离子电切术后与对照组术后病理明确肌层浸润率(6.98%vs. 7.14%)比较,差异无统计学意义(P>0.05);而二次等离子电切术后肌层浸润率明显高于对照组(20.93%vs. 7.14%),差异有统计学意义(P<0.05);观察组复发率明显低于对照组(2.94%vs. 18.46%),差异有统计学意义(P<0.05)。 结论 二次等离子电切术可以最大限度清除肿瘤组织,提供精准的病理分期,降低复发率,且术中及术后并发症无明显增加。非肌层浸润性膀胱肿瘤行二次等离子电切术可以使患者获益,值得临床推广。
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| 关 键 词： | 非肌层浸润性膀胱癌 二次电切术 临床应用 |
| 收稿时间： | 2020-03-06 |
Application of the repeat plasmakinetic resection in non-muscular invasive bladder tumor |
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| Affiliation: | Department of Urology, the First Affliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China |
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| Abstract: | Objective To discuss the value of the repeat plasmakinetic resection(Re-PKRBt) in non-muscular invasive bladder tumor. Methods A retrospective analysis was performed on 113 patients with non-muscular invasive bladder tumor who underwent plasmakinetic resection of bladder tumor in the Department of Urology, the First Affiliated Hospital of Bengbu Medical College from July 2017 to January 2019. Among them, 43 patients who underwent Re-PKRBt 4-6 weeks after first plasmakinetic resection were in observation group, while the remaining 70 patients who underwent single plasmakinetic resection were in control group. The following clinical data were recorded and analyzed, including the general data:gender, age, BMI, tumor size, number, preoperative staging, and pathological grading; the operation related information:indwelling catheterization time, intraoperative and postoperative complications, etc.; the postoperative pathological and prognostic data:positive rate of Re-PKRBt, postoperative pathological staging of the two groups of patients and local recurrence rate after 12 months of follow-up, etc. Results There was no significant difference between the two groups in general information and operation related information(all P>0.05). In the observation group, 3 patients(6.98%) showed urothelial tumor cells after Re-PKRBt. There was no significant difference concerning the invasion rate of muscle layer between first plasmakinetic resection in the observation group and the control group(6.98% vs. 7.14%). The invasion rate of muscle layer after secondary plasmakinetic resection in the observation group was significantly higher than that of the control group(20.93% vs. 7.14%), and the difference was statistically significant(P<0.05). The recurrence rate of the observation group was significantly lower than that of the observation group(2.94% vs. 18.46%), and the difference was statistically significant(P<0.05). Conclusion Re-PKRBt can remove tumor tissues to the maximum extent, provide accurate pathological staging and reduce recurrence rate, and increase of intraoperative and postoperative complications is insignificantly. Re-PKRBt for non-muscular invasive bladder tumors can benefit the patients and is worthy of clinical promotion. |
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