经尿道二次电切治疗 T1期非肌层浸润性膀胱癌的临床研究

目的：探讨经尿道二次电切（Re‐TUR）治疗T1期非肌层浸润性膀胱癌的意义及安全性。方法该科于2013年1月至2014年11月接诊的41例T1期非肌层浸润性膀胱癌患者，首次膀胱肿瘤电切术后4～6周进行Re‐TUR治疗。其中男33例，女8例。首次手术肿瘤单发者24例，多发者17例。肿瘤最大直径大于或等于3 cm者13例，小于3 cm者28例。首次治疗均为经尿道膀胱肿瘤电切术，病理报告均为T 1期尿路上皮癌。结果41例患者均顺利完成手术，无严重并发症发生。术后病检7例有肿瘤残留或肿瘤复发（17．07％），其中的3例为肿瘤基底肿瘤残留，4例为新发肿瘤；1例患者Re‐T U R病理分级从G2升至G3。随访3～27个月（平均13．2个月），复发9例，其中Re‐T U R阳性者3例（42．86％，3／7），Re‐T U R阴性者6例（17．65％，6／34）。结论经尿道Re‐TUR治疗T1非肌层浸润性膀胱癌安全可行，其意义主要在于遴选出高危患者进一步积极治疗，对降低非肌层浸润性膀胱癌的复发率可能有一定作用。

Clinical research of repeat transurethral resection for treating stage T1 of non-muscle invasive bladder cancer

Objective To investigate the significance and safety of repeat transurethral resection(Re‐TUR) for treating stage T1 of non‐muscle invasive bladder cancer .Methods The clinical data were retrospectively analyzed on 41 cases of stage T1 of non‐muscle invasive bladder cancer in this department of our hospital from January 2013 to November 2014 .All cases underwent Re‐TUR at 4-6 weeks after primary surgery .Among them ,33 cases were male and 8 cases were female ,24 cases were single tumor and 17 cases were multiple tumors at first operation .The maximal tumor diameter was ≥ 3 cm in 13 cases and <3 cm in 28 cases . The first treatment was transurethral resection of bladder tumor(TURB‐t) .The pathological report was the stage T1 of urothelium cancer .Results All 41 cases were completed the operation smoothly ,and no serious complication occurred .In the postoperative pathological examination ,7 cases(17 .07% ) had tumor residue or tumor recurrence ,among them ,3 case had residue f tumor base and 4 cases were new onset tumor;the pathological grade at Re‐TUR in 1 case was increased from G2 to G3 .The follow up lasted for 3―27 months(average 13 .2 months) ,9 cases relapsed ,3 cases (42 .86% ,3/7) were positive at Re‐TUR and 6 cases(17 .65% , 6/34) were negative at Re‐TUR .Conclusion Re‐TUR for treating stage T1 of non‐muscle invasive bladder cancer is safe and feasi‐ble ,its significance to pick out high‐risk patient for conducting further active treatment ,which may have certain effect for reducing the recurrence rate of non‐muscle invasive bladder cancer .