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目的:探讨2μm激光汽化切除术与双极等离子切除术治疗高龄高危非肌层浸润性膀胱尿路上皮癌的疗效及安全性。方法:回顾性分析105例高龄高危非肌层浸润性膀胱尿路上皮癌患者,采用2μm激光组62例,双极等离子组43例。对2组之间的手术时间、手术并发症、术后留置尿管及住院时间、术后复发率等进行比较。结果:所有病人均安全度过围手术期,两组相比术后留置尿管时间及术后住院时间的差异无统计学意义。两组术后均行膀胱灌注化疗,术后复发率亦无明显差异。2μm激光组无闭孔神经反射并发症发生,双极等离子组闭孔神经反射发生率为12%(5/43),差异具有统计学意义。两组之间的手术时间(15.7±4.6)min vs(9.8±3.5)min,2μm激光组手术时间略长。结论:2μm激光汽化切除术与双极等离子切除术治疗高龄高危非肌层浸润性膀胱尿路上皮癌同样具有良好疗效,2μm激光汽化切除术可避免闭孔神经反射手术并发症的发生,在手术安全性上更具优势。
Objective: To investigate the efficacy and safety of 2 μm laser vaporization and bipolar plasmapheresis in the treatment of advanced non-muscle invasive bladder cancer with urothelial carcinoma. Methods: A retrospective analysis of 105 cases of high-risk non-muscle invasive bladder urothelial carcinoma patients, using 2μm laser group 62 cases, bipolar plasma group 43 cases. The operation time, operative complications, postoperative catheterization and hospital stay, postoperative recurrence rate and so on were compared between the two groups. Results: All patients were safe perioperative period, compared with postoperative indwelling catheter time and postoperative hospital stay was no significant difference. Intraperitoneal chemotherapy was performed in both groups after operation, and there was no significant difference in the recurrence rate after operation. The incidence of obturator nerve reflex in 2μm laser group was 12% (5/43), the difference was statistically significant. The operation time between the two groups was (15.7 ± 4.6) min vs (9.8 ± 3.5) min, and the operation time in the 2μm laser group was slightly longer. Conclusion: 2μm laser vaporization resection and bipolar plasmapheresis in the treatment of high-risk non-muscle invasive bladder urothelial carcinoma also have a good effect, 2μm laser vaporization resection can obstruct obturator nerve reflex complications, surgery More security on the edge.