The Clinical Value Of The Diagnostic Transurethral Resection Of Bladder Tumor

Aims: To evaluate the value of application in accurately clinical staging of bladder cancer by using diagnostic transurethral resection.Methods: Total 295 cases of bladder cancer patients were included in this research from 2000 to 2007 in our hospital, 199 cases of paitients were treated by traditional transurethral resection, 96 cases of paitients were treated by diagnostic transurethral resection. All the patients were diagnosed as"superficial bladder cancer"after preoperative ultrasound of urinary system, bladder CT or MRI, cystoscopy and positive lateral chest radiography. During continuous epidural anesthesia or general anesthesia, intravesical fluid volume control in 100ml~150ml or so, with the 5% glucose injection, to moderate bladder filling. 199 cases were treated by traditional transurethral resection of bladder tumor: Remove the tumor with a ring electrode, depth to the base of the submucosa and superficial muscle layer; remove the tumor diameter of 2.0 cm wide surrounding normal bladder mucosa, and the removal of the tumor tissue fragments aspirated from the bladder, censorship pathology; 96 cases were remedied by diagnostic transurethral resection of bladder tumor: Remove the tumor with a ring electrode, depth to the base of the submucosa and superficial muscle layer; remove the tumor diameter of 2.0 cm wide surrounding normal bladder mucosa, and then the removal of the tumor tissue fragments aspirated from the bladder, check no residual tissue fragments within the bladder after the base of the original tumor resected bladder muscle tissue, including some deep muscle, distribution pathological examination. Patients in both groups were law intravesical mitomycin. The clinical follow-up data will be analyzed retrospectively.Results: The results obtained above both groups after 2.5 years of clinical follow-up data were compared:â‘ Total of 199 cases received traditional transurethral resection of bladder cancer (control group), 53 patients of them lost follow-up at different time points, but recurrence of bladder cancer can not be find during the follow-up period. In the remaining 146 patients, 62 cases of bladder cancer recurrented, the recurrence rate was 42% (62/146); 19 cases of them progressed to invasive bladder cancer, with the rate of 13% (19/146); 9 cases can be find pelvic lymph node and distant metastasis with the ratio of 6% (9/146). According to the general condition of patients, the cases which have recurrence of bladder cancer hysterectomy with bladder or other treatment and follow-up alone.â‘¡96 cases received diagnostic transurethral resection of bladder tumor (study group). Among them, 5 patients of them lost follow-up at different time points, but recurrence of bladder cancer can not be find during the follow-up period. 8 cases had the base of myometrial invasion. According to the general condition of patients, cystectomy or other treatment were administrated for these 8 patients, and follow-up alone. 13 patients which lost fellow-up and had base of myometrial invasion enrolled in this follow-up data. In the remaining 83 patients, 23 cases of bladder cancer recurrence, the recurrence rate was 28% (23/83); 3 cases progressed to invasive bladder cancer. With the ratio of 4% (3/83) in total fellow-up patients. For the recurrence of patients, which have taken further treatments, were followed up separately. We analyzed the data of these two groups: In study group, bladder cancer recurrence rate decreased significently compared with the rate of 42% in control group (study group: 28%; p<0.05); In study group, the ratio which progressed to invasive bladder cancer was 4%, and this rate was decrease significently compared with the rate of control group (13%; p<0.05); In study group, the incidence of pelvic lymph node and distant metastasis were significantly reduced (p<0.05).Conclusions:(1) The diagnostic transurethral resection of bladder tumor can give a correct assessment on superficial bladder cancer.(2) The diagnostic transurethral resection of bladder tumor can increase the invasive bladder cancer diagnosed rate.(3) The diagnostic transurethral resection of bladder tumor can be extended tumor-free survival in short period after surgery, relatively.(4) The diagnostic transurethral resection of bladder tumor can replace the traditional transurethral resection of bladder tumor as superficial bladder cancer diagnosis and treatment methods.