| Objective:Compare curative effect of transurethral bladder tumor endoscopic submucosal dissection(BT-ESD)and transurethral resection for superficial bladder cancer.To explore the safety and feasibility of transurethral bladder tumor endoscopic submucosal dissection and to evaluate the clinical value of it.Methods:The clinical data of 54 patients with superficial bladder cancer were collected and analyzed from January 2015 to December 2016.Twenty-four patients were treated with transurethral bladder tumor endoscopic submucosal dissection and 30 patients were treated with TURBT.The operation time,Bleeding,bladder perforation,obturator nerve reflex and other related complications,catheter retention time,bladder continuous washing time,postoperative hospital stay and postoperative recurrence within one year.Postoperative intravesical instillation chemotherapy.Results:Two groups of patients were successfully completed.Twenty-four patients in the BT-ESD group had an independent lesion of 31,with a diameter of 10-40 mm,a complete removal of 28 tumors,and three chopped out.The operative time(73.33± 34.06)min in BT-ESD group was significantly higher than that in TURBT group(52±39.73)min(P <0.05).The bladder continuous washing time(0.667±0.817)d in BT-ESD group and TURBT group(1.33±0.99)d,the difference was statistically significant(P <0.05).The catheter retention time(3.375±1.24)d in BT-ESD group and(5.40±1.99)d in TURBT group,the difference was statistically significant(P <0.05).The hospitalization time of BT-ESD was less than that of TURBT group(P =0.001).BT-ESD group had 1 case of bleeding;TURBT group closed-cell nerve reflex in 7 cases,bladder perforation in 2 cases,bleeding in 5 cases,postoperative hospital stay> 7 days in 11 cases,a total of 11 patients with complications.The incidence of complications was statistically significant(P <0.05).The incidence of obturator reflex and postoperative hospital stay is greater than 7 days in TURBT group was significantly higher than that in BT-ESD,and the difference was statistically significant(P <0.05).There was no significant difference in perforation and bleeding between the two groups(P> 0.05).BT-ESD group of 15 patients were followed up for 12 months,no recurrence.TURBT group of 19 patients were followed up for 12 months,6 patients with recurrence,the recurrence rate of 31.58%(6/19),the difference was statistically significant(P <0.05).Conclusion:1.Transurethral bladder tumor endoscopic submucosal dissection as a superficial bladder cancer minimally invasive treatment is safe and effective.2.Transurethral bladder tumor endoscopic submucosal dissection complete resection of tumor tissue specimens well preserved,so that pathologists more accurate tumor staging,has importance clinical significance of follow-up treatment,prognosis.3.Transurethral bladder tumor endoscopic submucosal dissection compare with transurethral resection of the baldder tumor can significantly reduce the surgical complications,improve the surgical results,shorten the postoperative recovery time.4.Short-term follow-up of Transurethral bladder tumor endoscopic submucosal dissectioncan significantly reduce the recurrence rate of patients after surgery. |
