绿激光和RevoLix 2微米激光治疗浅表性膀胱肿瘤的比较研究

目的比较选择性绿激光和RevoLix 2微米激光手术系统治疗浅表性膀胱肿瘤的安全性及疗效。方法选择性绿激光和RevoLix 2微米激光手术系统治疗浅表性膀胱肿瘤各42例,全部肿瘤均为膀胱移行细胞癌,肿瘤病理分级为G1～G2,临床分期为T1～T2。绿激光组采用非接触式绿激光治疗系统,对肿瘤进行汽化切除;2微米激光组采用RevoLix 2微米激光手术系统,对肿瘤予以汽化切割。结果2组手术均成功,所有患者均未输血,无闭孔神经反射及膀胱穿孔、尿外渗,无水中毒。绿激光组手术时间（15.3±10.5）min与2微米激光组（14.3±6.5）min无统计学差异（t=0.525,P=0.601）;绿激光组尿管留置（6.3±0.5）d与2微米激光组（6.3±1.2）d无统计学差异（t=0.000,P=0.999）;绿激光组术后住院（6.3±3.5）d与2微米激光组（7.2±2.4）d无统计学差异（t=-1.374,P=0.173）。术后随访半年,绿激光组5例复发,复发率11.9%（5/42）,2微米激光组3例复发,复发率7.1%（3/42）,2组复发率无统计学差异（χ2=0.138,P=0.710）。结论选择性绿激光和RevoLix 2微米激光手术系统治疗浅表性膀胱肿瘤都有效和安全,术中、术后并发症少,术后复发率低,但对其长远疗效尚须进一步观察,对T2期以上的膀胱肿瘤应采用开放手术治疗。

Comparative Study of Greenlight Photos Selective Vaporization and Revolix 2 Micron Continuous Wave Laser Vaporesection for the Treatment of Superficial Bladder Tumor

Objective To compare the safety and efficacy of greenlight photos selective vaporization and RevoLix 2 micron continuous wave laser vaporesection for the treatment of superficial bladder tumor. Methods Under sacral anesthesia or epidural anesthesia, a total of 42 patients with superficial bladder tumor were treated with greenlight photos selective vaporization while the other 42 patients received the RevoLix 2 micron continuous wave laser Vaporesection. The clinical stage of the patients was T1 - T2 , and the pathology grade was G1 - G2. Results The greenlight photos selective vaporization and RevoLix 2 micron continuous wave laser vaporesection were successfully completed in all of the patients. No patients required blood transfusion. No complications such as obturator nerve reflex, bladder perforation or overhydration occurred. No significant difference was noticed in the operation time （15.3±10.5） min vs （14.3 ±6.5） min, t =0.525, P=0.601],catheterization time （6.3±0.5） d vs （6.3 ±1.2） d, t = 0.000, P=0.999], and postoperative hospital stay （6.3 ±3.5） d vs （7.2±2.4） d, t= -1.374, P=0.173]. The patients were followed up for 6 months, during the period the recurrence rate was 11.9% （5/42） and 7.1% （3/42） respectively in the greenlight group and RevoLix group （Χ^2 =0. 138, P = 0. 710）. Conclusions Both greenlight photos selective vaporization and RevoLix 2 micron continuous wave laser vaporesection are effective and safe for superficial bladder tumor and lead to low rates of postoperative complications and recurrence. Further studies are necessary to evaluate its long-term effect. For T2 and higher grades of bladder tumors, open surgery should be performed.