Efficacy Analysis Of Precise Electroresection With Bipolar Plasma Needle Electrode In The Treatment Of Non-muscular Invasive Bladder Cancer

Objective:Analysis of a bipolar plasma needle electrode precision cutting technique with the traditional electric transurethral resection of bladder tumor cut method(TURBT)the curative effect of the treatment of muscular layer of invasive bladder cancer.Method:The clinical data of 57 patients with bladder cancer admitted to our department from August 2017 to December 2019 were retrospectively analyzed.All the enrolled patients met the following conditions:(1)All the 57 patients with bladder tumor had single onset.(2)Preoperative CT and pelvic nuclear magnetic examination showed no bladder muscle infiltration.(3)Pyelography revealed no abnormalities in bilateral upper urinary tract.(4)Postoperative pathology confirmed non-muscular invasive urothelial carcinoma of the bladder.(5)The tumor diameter was <3cm.(6)All patients had no serious cardiopulmonary diseases,normal coagulation function,and could tolerate surgical treatment.The 57 patients were divided into two groups,including 29 patients in the bipolar plasma acicular electrode group,including 18 males and11 females.The age was 48 to 81 years old,the average age was(64.5±16.6)years old.There were 29 tumors with an average size of(2.1±0.6)cm.There were 28 patients in the traditional TURBT group,including 16 males and 12 females.The age was 45 to 78 years old,the average age was(61.5±15.9)years old.There were 28 tumors with an average size of(2.2±0.8)cm.There was no statistical difference in gender,age,tumor size and other general information between the two groups(p>0.05).The average operation time,intraoperative blood loss,incidence of obturator nerve reflex,postoperative bladder irrigation time,average length of hospital stay and tumor recurrence rate 1 year after operation were compared and analyzed between the two groups.Results:All the 57 cases were performed by the same surgeon.The normal bladder mucosa of 0.5～1.0cm around the base of the tumor was marked by electrocoagulation in the bipolar plasma needle electrode group,and then the tumor was completely excised according to the surgical principle of precise electric resection of the bladder tumor,and the resection depth reached to the muscular layer.In the TURBT group,stratified resection of the bladder tumor was performed according to the principle of traditional TURBT surgery and the normal bladder mucosa around the tumor was removed including 2cm.The surgical resection depth of the tumor was the same as that of the bipolar plasma needle electrode group.The mean operation time was(20.37±4.32)min,the mean intraoperative blood loss was(43.65±4.25)ml,the mean incidence of obturator nerve reflex was 0.00%(0 cases),the mean postoperative bladder irrigation time was(23.88±8.12)h,the mean hospital stay was(3.61±1.05)d,and the tumor recurrence rate was 3.45%(1 case)in the bipolar plasma acicular electrode group.However,in the TURBT group,the average operative time was(26.65±3.42)min,the average intraoperative blood loss was(90.41±4.37)ml,the intraoperative incidence of obturator nerve reflex was 17.86%(5 cases),the average postoperative bladder irrigation time was(32.39±11.54)h,the average hospital stay was(4.68±1.17)d,and the tumor recurrence rate was28.57%(8 cases)one year after surgery.The mean operation time,intraoperative blood loss,intraoperative incidence of obturator nerve reflex,postoperative bladder irrigation time,average hospital stay,and tumor recurrence rate 1 year after surgery in the bipolar plasma acicular electrode group were all superior to the traditional TURBT group,with statistical significance(p <0.05).Conclusion:(1)Compared with traditional TURBT,bipolar plasma acicular electrode has the characteristics of less damage to surrounding tissues,shorter operation time and better hemostasis in the process of precise electroresection of non-muscular invasive bladder cancer.(2)Accurate electroresection with bipolar plasma needle electrode can reduce the incidence of obturator nerve reflex.(3)Precise electrotomy with bipolar plasma needle electrode can shorten the hospitalization period and the time of bladder irrigation,and reduce the psychological pressure of patients.(4)Compared with traditional TURBT,accurate electroresection with bipolar plasma needle electrode can reduce tumor recurrence rate and improve patient prognosis.