Comparison Of Endoscopic Therapies For Non-muscle Invasive Bladder Cancer: Bladder Tumor Endoscopic Submucosal Dissection Versus Transurethral Resection Of Bladder Tumor

Objective:The objective of this study is to explore the clinical effect and safety of bladder tumor-endoscopic submucosal dissection(BT-ESD)for treatment of non-muscle invasive bladder cancer(NMIBC).Methods: From August 2014 to March 2017,bladder tumors in 42 patients were resected by using BT-ESD(n = 14)or TURBT(n = 28).The patients were analyzed and compared to find out differences in procedure time,procedure-related complications,postoperative time of hospitalization and indwelling catheter,and recurrence between the two groups by SPSS18.0.Results:The differences in operation time between the two groups were statistically significant(BT-ESD:58.57±8.42 min,TURBT:48.21±13.59min;P<0.05).The postoperative hospitalization day[4.50(4.00,5.25)days] and obturator nerve reflex[ONR:2/14(14.3%)] were significantly lower in BT-ESD group than those in TURBT group [5.50(5.00,6.75)days,ONR 14/28(50.0%)],respectively)(P<0.05).No bladder perforation were found in all patients.The mean time of indwelling catheter after operation for BT-ESD and TURBT did not differ significantly[(3.82±1.15)days Vs.(4.23±1.35)days,P>0.05].Postoperative follow-up was performed for1 year.Recurrence was noted one year after surgery,and one patient in BT-ESD group(1/14,7.1%),and five cases in TURBT group(5/28,17.9%)showed postoperative recurrence.Conclusion :BT-ESD is favourable to be feasible alternative treatment for NMIBC with fewer incidence of obturator nerve reflex,postoperative hospitalization day and similar rate of recurrence.Besides,it can provide intact and eschar-free specimen for the pathological evaluation,especially the accurate evaluation of tumor stage to predict postoperative prognosis and guide subsequent treatment.