| Objective:To compare the clinical efficacy of transurethral holmium laser resection of bladder tumor and transurethral electroresection in non muscleinvasive bladder cancer and investigate the technique advantages of transurethral holmium laser resection of bladder tumor, provide a reference for holmium laser technology used in the treatment of bladder cancer. Methods:From Sep. 2013 to Mar. 2015, 68 patients with bladder tumor underwent HOLRBT in our urinary center. There were 49 men and 19 women, and their age ranged from 30 to 86 years old, the average age was(62.37±11.68) years. The tumor diameter ranged from 0.2cm to 4.0cm, the average diameter was(1.73±0.81)cm, there were 63 patients’ tumor diameter under 3cm, others were more than 3cm. The number of single tumor was 41 cases, 27 cases of multiple, 59 patients were the primary tumor, 9 cases of recur. All these patients were diagnosed of bladder tumors by high resolution imaging and cystoscope.We compared HOLRBT with TURBT in the following aspects: patients’ genger, patients’ age, size of tumor, numbor of tumor, primary or recurrent of tumor, operative time, Intraoperative complications, catheter indwelling time, postoperative hospital stay, hospitalization expense and tumor recur. Results:Two groups of patients in gender, age, tumor size, number of tumors, primary or recurrent of tumor context is different, but the difference between groups was not statistically significant(p=0.748,p=0.628,p=0.117, p=0.782 and p=0.573).The procedures were performed successfully in all these patients. The HOLRBT group mean operative time was(20.90±13.51) min, while the TURBT group mean operative time was(28.94±14.36)min, and the difference between groups was statistically significant(p<0.05). TURBT group had one case of bladder perforation, 9 cases of obturator nerve reflex, two cases of postoperative bleeding. The HOLRBT group didn’t happen this complications. TURBT group, one patient because of the tumor is located right ureter opening position, after 4d appeared on the right side back pain and fever. After the right of the renal pelvis callui, these symptoms were disappeared. About the catheter indwelling time and average hospitalization expense, HOLRBT group were more than TURBT group, and the difference between groups was statistically significant(p < 0.05,p=0.002). While on the average postoperative hospital stay context is different, but the difference between groups was not statistically significant(p=0.239).Two groups of patients were pathologically confirmed urothelial carcinoma, while TURBT group had five cases of morphological unclear on tumor base. Their recurrence cases were 10, 13 respectively among TURBT and HOLRBT, and the difference has no significance(p=0.517). Conclusion:Compared with TURBT, HOLRBT is safe and effective in the treatment of NMIBC, It can significantly reduce the incidence of intraoperative complications, improve surgical safety. The method of intraoperative laser ablation depth to superficial muscle or deep muscle, some patients with resectable part of all of the bladder wall, depth to expose the bladder outside the adipose tissue, thereby reducing the risk of recurrence of tumor in situ. Holmium laser resection clear vision, can clearly grasp the full thickness of the bladder wall layered dissection, which can achieve the purpose of partial resection of the bladder. HOLRBT can provide a complete tumor tissue structure, on tumor staging, grading more precise, its effect is equivalent to an open or laparoscopic partial resection of the bladder. HOLRBT is worth of promting in clinical. |
PDF Full Text Request