钬激光与等离子电切治疗浅表性膀胱尿路上皮癌的疗效比较

目的:比较钬激光与经尿道等离子电切治疗浅表性膀胱尿路上皮癌的疗效和安全性。方法:用钬激光和经尿道等离子电切分别连续治疗非肌层浸润性膀胱癌各30例，比较两组年龄、性别、肿瘤数、肿瘤大小、肿瘤分级、手术时间、闭孔神经反射发生率、膀胱穿孔例数、手术成功例数。结果:两组患者年龄、性别、肿瘤数、肿瘤大小、肿瘤分级、膀胱穿孔例数、手术成功例数差异无统计学意义（P>0.05），经尿道等离子电切组闭孔神经反射发生率为40.0%，钬激光治疗非肌层浸润性膀胱癌组无闭孔神经反射（P=0.000），且手术时间明显短于经尿道等离子电切组（P=0.000）。结论:钬激光与经尿道等离子电切治疗非肌层浸润性膀胱癌均有效，但钬激光治疗非肌层浸润性膀胱癌较经尿道等离子电切更安全、手术时间更短。

The comparison between holmium laser and bipolar transurethral resection in saline for the treatment of non-muscle invasive bladder urothelial cancer

Objective:To compare the efficacy and safety between holmium laser and bipolar transurethral resection in saline of non-muscle invasive bladder urothelial cancer.Methods:Sixty consecutive cases were equally divided into 2 groups according to the surgical technique:Holmium laser and bipolar transurethral resection in saline.Patient characteristics (including age，gender，number of tumor，tumor size，tumor grade，perioperative variables such as operative time，incidence of obturator nerve reflex，incidence of bladder perforation，success rate of surgery) were compared between 2 groups.Results:The differences of age，gender，number of tumor，tumor size，tumor grade，bladder perforation，success rate of surgery between 2 groups were no statistical significant (P>0.05).The incidence of obturator nerve reflex in bipolar transurethral resection in saline group was 40.0%.However，no obturator nerve reflex was observed in holmium laser group.Moreover，the operative time in holmium laser group was significantly shorter than that in bipolar transurethral resection in saline group（P=0.000）.Conclusion:Holmium laser and bipolar transurethral resection in saline were both effective for the treatment of non-muscle invasive bladder urothelial cancer.Holmium laser is much safer than bipolar transurethral resection in saline with shorter operative time.