Accurate Resection Of Bladder Tumors With Transurethral Pin-shaped Bipolar Plasmakinetic Electrode In The Treatment Of Non-muscule Invasive Bladder Cancer:A Preliminary Study

Purpose:To compare the efficacy and safety of Enucleation of bladder tumors with pin-shaped bipolar plasmakinetic electrode and conventional transurethral bipolar plasma annular electrode resection in the treatment of non-muscule invasive bladder cancer.Method:From September 2016 to May 2018,65 patients with non—muscle invasive bladder cancer(NMIBC)confirmed by cystoscopy and pathological biopsy were selected and analyzed retrospectively.According to the different surgical methods,the patients were divided into two groups: ATRBTPBPE group: transurethral en-bloc resection of bladder tumors with pin-shaped bipolar plasmakinetic electrode in 30 cases;CTUBPAERBT group: conventional transurethral bipolar plasma annular electrode resection of bladder tumors in 35 cases.The age,sex,tumor size,growth site,number of tumors,preoperative hemoglobin,operation time,indwelling time of urinary catheter,hospitalization time,incidence of obturator nerve reflex,depth of pathological specimen,recurrence rate of 9-20 months after operation,operation complications(obturator nerve reflex,bladder perforation)and hemoglobin 2 hours after operation were analyzed and compared.Continuous bladder irrigation time,indwelling catheter time after operation,hospitalization time after operation,staging and grading of pathological specimens after operation,existence of muscle tissue in pathological specimens after operation,follow-up time after operation and recurrence rate after operation,etc.Result:Sixty-five cases were successfully performed by the same senior physician once.The operation was performed under general anesthesia without obturator nerve block.Needle electrodes and annular electrodes were used to completely remove the visible tumors.The age,sex,size of tumors,number of tumors,shape,location of tumors and preoperative hemoglobin of the two groups were compared by independent sample t test,Pearson chi-square test and Fisher's exact test.There was no significant difference in preoperative indicators between the two groups(P > 0.05).There was no significant difference in operation time,hemoglobin 2 hours after operation,continuous bladder irrigation time,indwelling catheter time and hospitalization time between the two groups(P > 0.05);there was significant difference in the incidence of intraoperative complications(obturator nerve reflex)between the two groups(P < 0.05);there was one case of intraoperative bladder perforation in CTUBPAERBT group.There was no significant bleeding,indwelling catheter for 6 days,no serious complications.The incidence of bladder perforation was not significantly different between the two groups after removal of catheter.There was no significant difference in the stage of pathological specimens between the two groups(P > 0.05).The positive rate of basal burn injury in pathological specimens of the two groups was significantly lower in ATRBTPBPE group than in CTUBPAERBT group(P < 0.05).There was no significant difference in the follow-up time between the two groups(P > 0.05);there was significant difference in the number and location of recurrence of tumors between the two groups 9-20 months after operation(P < 0.05).Conclusion:1.Accurate resection of bladder tumors with transurethral pin-shaped bipolar plasmakinetic electrode and conventional transurethral bipolar plasma annular electrode resection of bladder tumors are safe and effective in the treatment of non-muscule invasive bladder cancer,and can completely remove visible tumors.2.Compared with conventional transurethral bipolar plasma annular electrode resection of bladder tumors,Accurate resection of bladder tumors with transurethral pin-shaped bipolar plasmakinetic electrode for non-muscule invasive bladder cancer more in line with the principle of non-tumor,can obtain better quality pathological specimens,is conducive to accurate pathological staging and grading,can reduce the recurrence rate of tumors,and can reduce obturator neural reflex,and it is worthy of clinical promotion.