Analysis on the curative efficacy of bladder tumor endoscopic submucosal dissection in the treatment of non-muscle invasive bladder cancer
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摘要: 目的 探讨非肌层浸润性膀胱癌患者采用膀胱肿瘤内镜黏膜下剥离术(BT-ESD)治疗的临床效果。 方法 将62例非肌层浸润性膀胱癌患者随机分为经尿道膀胱肿瘤切除术(TURBT)组、经尿道钬激光膀胱肿瘤切除术(HOLRBT)组和BT-ESD组,观察并比较3组的手术情况及治疗效果。 结果 3组患者手术均成功, BT-ESD组的术中出血量显著少于TURBT组与HOLRBT组(P<0.05), 尿管留置时间、术后住院时间显著短于TURBT组与HOLRBT组(P<0.05); TURBT组发生13例闭孔神经反射、2例膀胱穿孔, HOLRBT组发生1例膀胱穿孔, BT-ESD组发生3例闭孔神经反射, BT-ESD组的并发症发生率显著低于TURBT组(P<0.05); BT-ESD组肿瘤分期均准确,且患者术后复发率及原位复发率均显著低于TURBT组(P<0.05)。 结论 采用BT-ESD治疗浅表性膀胱肿瘤患者,创伤小,安全性高,患者痛苦少,肿瘤切除完整,肿瘤分期准确,复发率低,疗效确切。
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关键词:
- 非肌层浸润性膀胱癌 /
- 膀胱肿瘤内镜黏膜下剥离术 /
- 经尿道钬激光膀胱肿瘤切除术 /
- 经尿道膀胱肿瘤切除术
Abstract: Objective To investigate the clinical efficacy of bladder tumor endoscopic submucosal dissection(BT-ESD)in the treatment of non-muscle invasive bladder cancer. Methods A total of 62 patients with non-muscle-invasive bladder cancer were randomly divided into three treatment groups: transurethral resection of bladder tumor(TURBT)group, transurethral holmium laser resection of bladder tumor(HOLRBT)group, and BT-ESD. The surgical conditions and curative effects of three groups were observed. Results All three groups successfully completed the operations. Perioperative bleeding amount during surgery in the BT-ESD group was significanlly less, indwelling time and postoperative hospital stay were significantly shorter than the other two groups(P<0.05). Obturator nerve reflex occurred in 13 cases in the TURBT group, and 3 cases in the BT-ESD group, bladder perforation in 2 cases in the TURBT group, and 1 case in HOLRBT group. The incidence of complications in the BT-ESD group was significantly lower than that in the TURBT group(P<0.05). The patients in the BT-ESD group had accurate tumor staging, and their postoperative and in situ recurrence rate were significantly lower than those in the TURBT group(P<0.05). Conclusion BT-ESD has less trauma, higher safety, less pain, complete tumor resection, accurate tumor staging, and lower recurrence rate in the treatment of superficial bladder tumors. -
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