Comparative Study Of Transurethral Thulium Laser Resection And Plasmakinetic Resection For Non-Muscle Invasive Bladder Cancer

Objective:To investigate the clinical effect of TmLRBT in the treatment of non-muscle invasive bladder cancer by comparing transurethral Tm:YAG laser resection of bldder tumor(TmLRBT)and transurethral bipolar plasmakinetic resection of bladder tumor(PKRBT).Methods : In this study,58 patients with non muscle-invasive bladder cancer(NMIBC)treated with transurethral bladder tumor Tm:YAG laser resection(TmLRBT)or transurethral bladder tumor bipolar plasmakinetic resection(PKRBT)admitted to our hospital from January 2017 to June 2018 were selected.Among them,31 patients received transurethral bladder tumor Tm:YAG laser resection group(TmLRBT),and 27 patients received transurethral bladder tumor bipolar plasmakinetic resection group(PKRBT).The operative time,postoperative hemoglobin decline,incidence of intraoperative obturator nerve reflex and bladder perforation,postoperative indwelling catheter time,postoperative hospitalization time and postoperative bladder tumor recurrence rate were analyzed retrospectively.The collected data were processed by SPSS24.0 statistical software,and the counting data were tested bychi-square test;if the measurement data obeyed the normal distribution,T test was used;if the measurement data did not obey the normal distribution,the rank sum test was used.There was significant difference between the two groups(P <0.05).Results: First,the average time of operation,the average time of indwelling three-chamber catheter and the average time of postoperative hospitalization in TmLRBT group(as followed:22.84±5.67 min,2.09±1.04 d,4.17±1.38 d)were shorter than those in PKRBT group(as followed:28.63±9.44 min,3.33±1.90 d,5.22±2.22 d),and there were significant differences between the two groups(P < 0.05).Second,the incidence of obturator nerve reflex in TmLRBT group(0%)was lower than that in PKRBT group(29.6%),and there was significant difference between the two groups(P < 0.05).Last,there was no significant difference in the changes of hemoglobin before and after operation(5.39±5.36 g/L vs 5.77±6.18 g/L),the incidence of bladder perforation(0% vs 11.1%)and the recurrence rate of bladder tumor(12.9% vs25.9%)between TmLRBT group and PKRBT group(P > 0.05).Conclusion: TmLRBT can shorten the operation time,postoperative catheter indwelling time and postoperative hospital stay,and can avoid the occurrence of obturator nerve reflex.TmLRBT is safe and feasible in the treatment of non muscle-invasive bladder cancer.