| 马光,李红阳,宋殿宾,等.经尿道钬激光整块切除术治疗高危非肌层浸润性膀胱癌 47例疗效及术后并发症与复发风险的观察[J].安徽医药,2024,28(4):804-808. |
| 经尿道钬激光整块切除术治疗高危非肌层浸润性膀胱癌 47例疗效及术后并发症与复发风险的观察 |
| Effect of transurethral holmium laser bulk resection in treatment of 47 cases with high-risk non-muscle invasive bladder cancer and its effect on postoperative recovery, complications and recurrence risk |
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| DOI：10.3969/j.issn.1009-6469.2024.04.036 |
| 中文关键词: 膀胱肿瘤 膀胱切除术 钬激光 非肌层浸润性膀胱癌 并发症 复发 |
| 英文关键词: Urinary bladder neoplasms Cystectomy Holmium laser Non-muscle invasive bladder cancer Complications Recurrence risk |
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| 中文摘要: |
| 目的探讨经尿道钬激光整块切除术治疗高危非肌层浸润性膀胱癌(NMIBC)的效果。方法选取 2019年 1月至 2021年 5月承德医学院附属医院 94例高危 NMIBC病人进行前瞻性研究，按随机数字表法分组，各 47例。对照组行经尿道膀胱肿瘤等离子电切术，观察组行经尿道钬激光整块切除术。比较两组手术相关指标、临床疗效、手术前后外周血循环肿瘤细胞(CTCs)计数、肿瘤标志物［癌胚抗原(CEA)膀胱肿瘤抗原(BTA)、糖链抗原 19-9(CA19-9)］、并发症及预后情况。结果观察组术中出血量、膀胱冲洗、尿管留置及术后住院、时间分别为( 25.10±4.12)mL、(18.65±6.74)min、(19.57±3.48)h、(8.01±1.69)d，均优于对照组的 |
| 英文摘要: |
| Objective To investigate the effect of transurethral holmium laser bulk resection in the treatment of high-risk non-muscle invasive bladder cancer (NMIBC).Methods A prospective study was conducted on 94 high-risk NMIBC patients in the Affiliated Hos?pital of Chengde Medical College from January 2019 to May 2021. They were randomly assigned into two groups, with 47 cases in eachgroup. The control group underwent transurethral bladder tumor plasma electrosection, while the observation group underwent transure?thral holmium laser bulk resection. The surgery-related indicators, clinical efficacy, and peripheral blood circulating tumor cell (CTC)count before and after surgery were compared between the two groups. The tumor markers [carcinoembryonic antigen (CEA), bladder tu?mor antigen (BTA), carbohydrate antigen 19-9 (CA19-9)], the complications and prognosis of the two groups were compared. Results The intraoperative blood loss, bladder irrigation, indwelling catheter, and postoperative hospitalization time in the observation groupwere (25.10±4.12) mL, (18.65±6.74) min, (19.57±3.48) h, and (8.01±1.69) d, respectively, which were all superior to those in the con?trol group of (43.25±6.78) mL, (24.78±8.12) min, (35.24±5.12) h, and (15.32±2.89) d (P<0.05); the total effective rate in the observa? tion group was 87.23%, which was higher than that in the control group 68.09% (P<0.05); the peripheral blood CTCs count in the obser?vation group at 72 hours after surgery was 5.47±2.00, which was lower than that in the control group 8.96±3.12 (P<0.05); the serum BTA, CEA, and CA19-9 levels in the observation group were lower than those in the control group at 3, 6, and 12 months after surgery (P<0.05); the complication rate in the observation group was 6.38%, which was lower than that in the control group of 23.40% (P<0.05);after one year of follow-up, the one-year recurrence-free survival rate in the observation group was 97.83% (45/46) and in the controlgroup was 90.91% (40/44), and the difference was not statistically significant (P>0.05).Conclusion Transurethral holmium laser bulk resection can improve the clinical efficacy of high-risk NMIBC patients, reduce complications, speed up the postoperative recovery pro?cess, reduce peripheral blood circulating tumor cells, and reduce tumor marker levels. |
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