钬激光与经尿道膀胱肿瘤切除术治疗非肌层浸润性膀胱癌的比较。

Comparison of Thulium Laser Resection of Bladder Tumors and Conventional Transurethral Resection of Bladder Tumors for Non-Muscle-Invasive Bladder Cancer.

机构信息

Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Hubei Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Urol Int. 2022;106(2):116-121. doi: 10.1159/000514042. Epub 2021 Mar 30.

DOI:10.1159/000514042

PMID:33784709

Abstract

INTRODUCTION

The thulium laser resection of bladder tumors (TmLRBT) was increasingly used in the treatment of non-muscle-invasive bladder cancer (NMIBC) recently, and here we report the relevant outcomes of our institution to evaluate its efficacy and safety.

METHODS

We retrospectively collected the data of NMIBC patients who underwent either TmLRBT or transurethral resection of bladder tumor (TURBT). The baseline characteristics and perioperative outcomes were compared in these 2 groups.

RESULTS

The TmLRBT had a higher rate of detrusor identification than TURBT (97.4 vs. 87.6%, p = 0.001). After screening, 134 patients who underwent TmLRBT and 152 patients who received TURBT were enrolled in the analysis, and their baseline characteristics were similar. During the TURBT, 24 (15.8%) obturator nerve reflexes and 9 (5.9%) bladder perforations occurred, while none happened during the TmLRBT. After surgery, TmLRBT patients had fewer postoperative gross hematuria (38.1 vs. 96.7%, p < 0.001) and postoperative irrigation (27.6 vs. 92.7%, p < 0.001), and its irrigation duration was significantly shorter (2.3 vs. 3.3 day, p < 0.001). During the follow-up, no significant difference in the recurrence rate was detected (p = 0.315).

CONCLUSIONS

TmLRBT is a safer technique than conventional TURBT in the treatment of NMIBC, and it could offer better specimens for pathologic assessment while the cancer control was not compromised.

摘要

介绍

近年来，铥激光膀胱肿瘤切除术（TmLRBT）在非肌肉浸润性膀胱癌（NMIBC）的治疗中越来越多地被应用，在此我们报告我们机构的相关结果，以评估其疗效和安全性。

方法

我们回顾性收集了接受 TmLRBT 或经尿道膀胱肿瘤切除术（TURBT）的 NMIBC 患者的数据。比较了两组患者的基线特征和围手术期结果。

结果

TmLRBT 的逼尿肌识别率高于 TURBT（97.4%比 87.6%，p=0.001）。筛选后，134 例接受 TmLRBT 和 152 例接受 TURBT 的患者被纳入分析，两组的基线特征相似。在 TURBT 过程中，有 24 例（15.8%）发生闭孔神经反射，9 例（5.9%）发生膀胱穿孔，而 TmLRBT 过程中均未发生。术后，TmLRBT 患者的肉眼血尿（38.1%比 96.7%，p<0.001）和术后冲洗（27.6%比 92.7%，p<0.001）较少，且冲洗时间明显缩短（2.3 天比 3.3 天，p<0.001）。随访期间，复发率无显著差异（p=0.315）。