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中国临床研究英文版:2018,31(9):1243-1246
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选择性经尿道膀胱肿瘤电切术治疗浸润性膀胱尿路上皮癌的可行性
(南通大学附属南京江北人民医院泌尿外科,江苏 南京 210048)
Feasibility of elective transurethral resection of bladder tumor for invasive bladder urothelial carcinoma
(Department of Urology, Nanjing Jiangbei People's Hospital Affiliated to Nangtong University, Nanjing, Jiangsu 210048, China)
摘要
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Received:April 10, 2018   Published Online:September 20, 2018
中文摘要: 目的 探讨选择性经尿道膀胱肿瘤电切术(TURBT)治疗肌层浸润性膀胱尿路上皮癌(MIBUC)的可行性及对患者生存质量的影响。方法 选择2010年6月至2013年6月期间收治的64例MIBUC患者,随机分为TURBT组与膀胱部分切除术(PC)组,各32例。对比两组的生存质量评分,用直接计算法计算并对比两组1、3、5年生存率。结果 TURBT组手术时间、术中出血量、术后膀胱冲洗时间、住院时间及并发症率均显著低于PC组(P<0.01);术后6个月,TURBT组生命质量测定量表(QLQ-C30)中功能评分、总体健康评分均显著高于术前及PC组,症状评分均显著低于术前及PC组(P<0.05,P<0.01);TURBT组中位无瘤生存期(DFS)及总生存期(OS)为34.56个月、45.11个月,与PC组的35.31个月、47.39个月比较差异无统计学意义(P>0.05);TURBT组复发率为30.00%,与PC组的27.59%比较差异无统计学意义(P>0.05);两组的1、3、5年无瘤生存率及总生存率比较差异无统计学意义(P>0.05)。结论 选择性TURBT治疗MIBUC,安全可行,能够减少手术创伤、加快患者术后康复速度并改善生活质量。
Abstract:Objective To investigate the feasibility of transurethral resection of bladder tumor(TURBT) for muscle-invasive bladder urothelial carcinoma (MIBUC) and its impact on quality of patients' life. Methods A total of 64 MIBUC patients operated from June 2010 to June 2013 were randomly divided into TURBT group and partial cystectomy (PC) group (n=32, each). The quality of life and 1-, 3-, 5-year survival rates were compared between two groups. Results The operative time, intra-operative blood loss, postoperative bladder irrigation time, hospital stay and complication rate in TURBT group were significantly lower than those in PC group (all P<0.01). At 6 months after operation, the functional scores and overall health score of Quality of Life Questionnaire Core 30(QLQ-C30) of TURBT group were significantly higher than those of preoperative and PC group, and symptom scores were significantly lower than those of preoperative and PC group (P<0.05, P<0.01). The disease-free survival (DFS) and overall survival (OS) times were 34.56 and 45.11 months in TURBT group and 35.31 and 47.39 months in PC group, and there were no significant differences between two groups (all P>0.05). Also, there were no significant differences in recurrence rate (30.00% vs 27.59%), 1-, 3-, 5-year DFS rates and OS rates between TURBT group and PC group (all P>0.05). Conclusion Selective TURBT is safe and feasible for the treatment of MIBUC, which can reduce surgical trauma, accelerate the recovery and improve the quality of life.
文章编号:     中图分类号:R 737.14 R 615    文献标志码:B
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