【摘要】 目的探讨经尿道内镜黏膜下剥离术(BT-ESD)治疗非肌层浸润性膀胱癌(NMIBC的有效性和安全性,以及影响BT-ESD疗效的因素。方法收集我院2013年11月至2019年6月行BT-ESD治疗的膀胱肿瘤患者150例,通过分析患者一般状况、肿瘤特征、术中状况、术后随访和复发情况等指标,利用卡方检验及t检验方法分析BT-ESD的疗效和安全性,并找出影响BTESD疗效的因素。结果截止2019年6月我院共完成BT-ESD手术161例,将术后病理证实为Ta/T1的150例患者纳入研究,其中男112例,女38例。切缘阴性切除率为99.3%(149/150),术中膀胱穿孔1例,术后出血3例,无手术死亡病例。单因素分析结果显示,肿瘤直径(P=0.032)及肿瘤病理分级(P=0.025)与肿瘤复发密切相关。截止2019年6月,BT-ESD术后累计无复发生存率为71.89%(最长随访时间63.08个月,平均随访时间34.63个月),其中随访满1、2、3、4和5年患者的无复发生存率为91.73%(122/133例)、88.18%(97/110例)、79.35%(73/92例)、67.50%(27/40例)和72.40%(12/17例)。结论本单中心回顾性研究证实BT-ESD治疗NMIBC安全、有效,可显著降低患者术后复发率。更多还原

【Abstract】 Objective To analyse the efficacy and safety of en bloc bladder tumor endoscopic sub-mucosal dissection(BT-ESD)in non-muscle invasive bladder cancer(NMIBC)patients by the single center retrospective observation. Methods A retrospective observation was carried out in Shaanxi Provincial People’s Hospital.From Nov.2013 to Jun.2019,161 cases of BT-ESD were performed,150 of which were eligible NMIBC(Ta/T1)patients.The operation time,blood loss,postoperative bladder irrigation time,catheter indwelling time,hospital stay and complications were observed and analyzed.All patients were under postoperative observation. Results Jun.2019,161 cases of BT-ESD were performed,150 of which were eligible NMIBC(Ta/T1).One case of bladder perforation and 3 cases of post-operative hemorrhage were observed,the R0 dissection rate was99.3%(149/150).The univariate analysis showed the tumor relapse was related to tumor grade(P=0.025)and tumor size(P=0.032).The 1-year,2-year,3-year,4-year and 5-year recurrent free survival rate were 91.73%,88.18%,79.35%,67.50% and 72.40% respectively.The accumulated recurrent free survival rate was 71.89%(Tmax:63.08 months,Tmedium:34.63 months). Conclusions The single center observation showed the BT-ESD lead to a safe and effective approach for NMIBC treatment,which decreased the recurrent rate.更多还原