再次经尿道电切术治疗非肌层浸润性膀胱尿路上皮癌临床分析

目的 探讨再次经尿道电切术(ReTUR)治疗非肌层浸润性膀胱尿路上皮癌的临床意义.方法 76例非肌层浸润性膀胱尿路上皮癌患者分别接受单次经尿道电切术(TUR)联合膀胱内灌注化疗(单次TUR组,n=38)或单次TUR、ReTUR联合膀胱内灌注化疗(ReTUR组,n=38).观察ReTUR组患者首次TUR术后肿瘤残存率和ReTUR术后重新分期率；首次TUR术后次日起对患者进行随访,比较两组患者肿瘤复发率.结果 ReTUR组患者首次TUR术后肿瘤残存率为31.6％,ReTUR术后重新分期率为10.5％.ReTUR组患者肿瘤复发率显著低于单次TUH组患者(2.8％和21.1％,P＜0.05).结论 ReTUR治疗非肌层浸润性膀胱尿路上皮癌可发现首次TUR术后的残存肿瘤,提高肿瘤分期的准确性,降低肿瘤复发率.

Clinical analysis of re-transurethral resection in management of non-muscle invasive bladder urothelial cancer

Objective To investigate the clinical value of re-transurethral resection(ReTUR) in the management of non-muscle invasive bladder urothelial cancer.Methods Seventy-six patients with non-muscle invasive bladder urothelial cancer received transurethral resection(TUR) combined with intravesical chemotherapy(single TUR group,n=38) or TUR,ReTUR combined with intravesical chemotherapy(ReTUR group,n=38).The rate of tumor residue after first TUR and rate of restaging after ReTUR in ReTUR group were observed.Patients were followed up after first TUR in two groups,and the rates of tumor recurrence were compared between two groups.Results In ReTUR group,the rate of tumor residue after first TUR was 31.6%,and the rate of restaging after ReTUR was 10.5%.The rate of tumor recurrence in ReTUR group was significantly lower than that in single TUR group(2.8% vs 21.1%,P<0.05).Conclusion Non-muscle invasive bladder urothelial cancer managed by ReTUR may discover residual tumors after first TUR,increase the accuracy of tumor staging,and decrease the rate of tumor recurrence.