The Application Of Endoscopic Monitor In The Transurethral Resection Of Bladder Tumor

Objective A kind of endoscopic surveillance system was used to monitor the amount of bleeding and absorption of flushing fluid by patients during the Transurethral Resection of Bladder Tumor (TURBT). And recording the change of the perioperative complications and relevant biochemical index of these patients, wishing to provide a first-hand information of the monitor’s clinical application for the TURBT. Help to promoting the prevention of the complications and the recovery of the postoperative homeostasis about the TURBT.Methods If the accuracy test which ruled out the errors come form the monitor are normal, we will take the clinical monitoring experiment. Before surgery, we set some physiological parameters of patients on the monitor interface; then let the flushing fluid get through the monitor’s component, such as the flow meter of monitor, rinses catheter, collection funnel, collecting barrel and so on; and recording the amount of bleeding and the absorptive amount of flushing fluid on the monitor’s screen and the occurrence about TURs, nervi obturatorius reflex and bladder perforation. After surgery, we record the changes of these patients’blood routine, ion and blood biochemical indicators. According to the different system used in operation for resecting, the patients are divided into Bipolar transurethral resection group and Monopolar transurethral group. Then, all records measured are made statistical analysis or statistical description.Results The accuracy test’s results can well rule out the errors form the monitor. There are a total of 17 patients in the bipolar transurethral resection group, the blood loss was 18.00±7.99ml, the absorption amount of flushing fluid was 29.79±21.19ml and operation time was 30.59±9.86min. And there are 13 patients in the monopolar transurethral group, the blood loss was 23.13±11.78ml, the absorption amount of flushing fluid was 27.18±16.40ml and the operation time was 31.85±8.91min. There are no obvious statistical significance(p>0.05)between the two group from the blood loss, the absorption amount of flushing fluid and the operation time. But the amount of bleeding and the operation time are Positive linear correlation (r=0.496, p=0.005) by correlation analysis which means that the increase of the blood loss are associated with the increase of operation time. And the absorption amount of flushing fluid and the time of operation also are Positive linear correlation(r=0.371, p=0.044). There are no TURs and bladder perforation in two groups, but 1 cases nervi obturatorius reflex in the bipolar transurethral resection while 3 cases in the monopolar transurethral group, the difference are no obvious statistical significance (p=0.17) By analyzing the diference of these patients’major biochemical indicators between surgery, we found that the changes of Ca2+、K+、RBC、PLT、WBC、NE%and LY% have statistical significance (p>0.05)Conclusion Endoscopic monitor indeed is a real-time and, accuracy, endoscopic surveillance system, which easy to operate and without through the human body. Although the operation time is shorter, the blood loss and the absorption amount of flushing fluid is less in the TURBT, it is still necessary to monitor for preventing some related complications. And the laboratory tests suggest surgeons that they should pay more attention to the changes of Ca2+、K+、RBC、PLT、WBC、NE%、 LY after TURBT.Objective To compare the effect and safety of Plasmakinetic bipolar transurethral resection with monopolar transurethral resection of bladder cancer.Methods All randomized controlled trials(RCT) of Plasmakinetic bipolar and Monopolar transurethral resection for the treatment of bladder tumor were collected. The quality of included RCTs was assessed. Relevant data were selected according to the standard of Cochrane systematic review. The statistical soft ware RevMan 5.2 was used for Meta analysis.Result 8 randomized controlled trials with 953 cases were included. The results showed that there was no significant difference in the bladder perforation rate[OR=0.17,95%CI(0.33,1.52), p=0.38] in the surgery, the 2-year recurrence rate [OR=0.62, CI95%(0.30,1.32),p=0.22] and the Catheterization time [SMD=-0.78,95%CI(-2.35,0.78), p=0.33] between the monopolar group and the bipolar group. Compared with the monopolar transurethral resection, the plasmakinetic bipolar transurethral resection had shorter procedure times[SMD=-2.42,95%CI(-4.61,-0.23), p=0.03], lesser blood loss during surgery[SMD=-15.65,95%CI(-22.40,-8.91),p<0.00001], lower incidence of Obturator nerve reflectivity [OR=0.54,95%CI (0.35,0.83),p=0.005] and higher scores of the life quality after surgery[SMD=19.26,95%CI (17.34,21.18),p<0.00001].Conclusions Plasmakinetic bipolar transurethral resection of bladder tumor can shorten the operation time, better control of blood loss during surgery, reduce the incidence of obturator nerve reflex, improve the quality of life of patients. More high-quality randomized controlled trials with large samples are required to verify the findings.