经尿道膀胱肿瘤电切术后膀胱黏膜下注射抗肿瘤药物防治肿瘤复发

目的　探讨预防浅表性膀胱癌经尿道膀胱肿瘤电切术 (TUR Bt)术后复发的新方法。方法　初发浅表性膀胱肿瘤TUR Bt术后膀胱黏膜下注射抗肿瘤药物 (比柔吡星 )患者 6 8例 (注射组 ) ,其中肿瘤单发 4 4例、多发 2 4例 ;以TUR Bt术后膀胱内灌注化疗药物的 74例患者作为对照 (灌注组 ) ,其中肿瘤单发 4 9例、多发 2 5例。根据随访结果对两种方法预防肿瘤复发的疗效进行评价。结果　注射组平均随访 38个月 ,对照组平均随访 35个月。注射组随访期内有 8例复发 (11 8% ) ,灌注组随访期内有 2 2例复发 (2 9 7% ) ,两组复发率相比 ,差异有非常显著意义 (χ2 =0 0 13,P <0 0 1) ;注射组和灌注组中 ,肿瘤单发与多发之间复发率相比 ,差异无显著意义 (χ2 =0 719,P >0 0 5 )。结论浅表性膀胱癌TUR Bt术后单次黏膜下注射抗肿瘤药物 ,操作简单、安全有效、副作用少、费用低 ,是治疗膀胱浅表肿瘤的一种实用方法 ,可有效地预防膀胱肿瘤术后复发。

Submucosal injection of anti-tumor drug on the prevention of Post-TUR-Bt recurrence

OBJECTIVE: To study a new and practical method to prevent the superficial bladder tumor recurrence after transurethral resection of bladder tumor (TUR-Bt). METHODS: We had chosen 68 patients with superficial bladder tumor randomly. After TUR-Bt, we inserted special stainless steel injection needle through the operation hole, and then injected anti-tumor drugs (pirarubicin) submucously; in the control group, 74 patients were given traditional perfusion therapy for carcinoma in bladder with the same anti-tumor drug (pirarubicin) after TUR-Bt. The effects were evaluated according to recurrence ratio. RESULTS: The recurrence rate of injection group was 11.8% (8/68), and that of the control group was 29.7% (22/74). There is a very significant difference between the two groups (chi(2) = 0.013, P < 0.01). The overall median recurrence interval period of injection group was obviously longer than that of the control group, but there was no significant difference about single and multiple occurrences between the two groups (chi(2) = 0.719, P > 0.05). CONCLUSIONS: The injection method used to prevent tumor recurrence after TUR-Bt has the following virtues: simple and safe, less side effect, more economical. We demonstrated that submucosal injection is a practical method to prevent tumor recurrence and is worth popularizing.