二次电切对T1G3期膀胱肿瘤疗效影响的回顾性分析

目的：探讨T1G3期膀胱肿瘤患者行第二次经尿道膀胱肿瘤电切术（TURBT）治疗的临床意义。方法：收集2005年1月～2010年4月，初次TURBT治疗后病理诊断为T1G3期膀胱肿瘤患者4周内行第二次TURBT治疗共23例（观察组）。以同期行TURBT后诊断为T1G3期膀胱肿瘤，但未行二次电切的37例患者为对照。两组患者术后均予以羟喜树碱行膀胱灌注治疗，观察两组间肿瘤复发率差异，残余肿瘤存在与否及位置，肿瘤病理分期、分级的变化，根据第二次TURBT的结果采取的不同治疗方案．结果：二次电切后发现7例（30％）有残余肿瘤，5例（23％）有肿瘤分期的升高，其中3例改行根治性膀胱切除术。随访10n18个月（平均13个月），有4例（17％）肿瘤复发。对照组19例（52％）肿瘤复发。结论：第二次TURBT治疗检测残存肿瘤，揭示肿瘤分期情况，提前确定患者是否应行根治性膀胱切除的重要依据及可明显降低肿瘤的复发与进展。

The Effect of a Second Transurethral Resection for T1G3 Bladder Cancer

Objective:In order to explore the clinical significance of the second transurethral resection for T₁G₃ bladder cancer（TURBT）.Methods:Twenty-three patients who were diagnosed T₁G₃ bladder cancer in the first TURBT,during 4 weeks do the second TURBT in the observed group.Meanwhile,thirty-seven who were diagnosed T₁G₃ bladder cancer by single TURBT as controls.Observing whether the existence of tumor residues,the location, and the changes in the pathological stage.Different treatment plans were instituted according to their outcomes of the second TURBT..Results:Tumor residues were found in 7 patients（30%） with the second TURBT and pathological stage were found increased in 5 patients（25%）,3patients insteaded the radical cystectomy of that. Tumor recurred in 4 patients（17%）in the observed group and 19（52%）in the control group after follow-up for 10 to 18 months（13 months in average）.Conclusions:The second TURBT is an effective method to treat for the patients with T₁G-3 bladder cancer to reveal their actual situation,evaluate their stages and examine residue of the tumor.At the same time,it also can decline recurrence and postpone the progression of the tumor.While,it is an important to make sure whether the patients should be underwent partial cystectomy or radical total cystectomy.