Safety analysis of negative pressure suction transurethral resection of bladder tumor for non-muscular invasive bladder cancer
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摘要: 目的 对比分析负压吸引经尿道膀胱肿瘤切除术与常规经尿道膀胱肿瘤切除术治疗非肌层浸润性膀胱癌的安全性。方法 分析2021年3月—2022年3月于山东第一医科大学第二附属医院泌尿外科诊断为非肌层浸润性膀胱癌并行经尿道膀胱肿瘤切除术的85例患者，根据术中是否应用负压吸引分为观察组(负压吸引经尿道膀胱肿瘤切除术)和对照组(常规经尿道膀胱肿瘤切除术)，比较两组相关数据，并进行统计学分析。结果 两组患者术前资料比较差异均无统计学意义。观察组较对照组手术时间更短[15(14.00，17.00) min vs.24(19.75，25.00) min]。观察组：43例均未发生膀胱穿孔；40例标本中有肌层组织，3例肌层组织缺失；术后重度膀胱痉挛1例，轻度膀胱痉挛10例，未发生膀胱痉挛32例；43例均未发生术后出血；40例无术后感染，3例出现术后感染；43例均未二次留置尿管。对照组：38例未发生膀胱穿孔，4例术中出现膀胱穿孔；32例标本中有肌层组织，10例肌层组织缺失；术后重度膀胱痉挛4例，轻度膀胱痉挛19例，未发生膀胱痉挛19例；38例未发生术后出血，4例发生术后出血；31例无术后感染，11例出现术后感染；37例未二次留置尿管，5例二次留置尿管。观察组均优于对照组，两组比较差异均有统计学意义(P < 0.05)。观察组无非计划再次手术，对照组1例患者术后出血较多并行非计划再次手术。结论 在术中应用负压吸引可显著提高经尿道膀胱肿瘤切除术治疗非肌层浸润性膀胱癌的安全性。
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关键词:
- 非肌层浸润性膀胱癌 /
- 经尿道膀胱肿瘤切除术 /
- 负压吸引 /
- 安全性 /
- 分析
Abstract: Objective To compare the safety between negative pressure suction transurethral bladder tumor resection and conventional transurethral bladder tumor resection in the treatment of non-muscular invasive bladder cancer.Methods A total of 85 patients diagnosed with non-muscular invasive bladder cancer who underwent transurethral bladder tumor resection in the Urology Department of Second Affiliated Hospital of Shandong First Medical University from March 2021 to March 2022 were analyzed, and the patients were divided into observation group (negative pressure suction transurethral bladder tumor resection) and control group (conventional transurethral bladder tumor resection) according to whether negative pressure suction was applied intraoperatively. The data of the two groups were compared and analyzed statistically.Results There was no significant difference in preoperative data between the two groups. The operation time of observation group was shorter than that of control group [15 (14.00, 17. 00) min vs. 24 (19.75, 25.00) min]. In the observation group, no bladder perforation occurred; muscularis tissue was found in 40 specimens and missing in 3; severe bladder spasm occurred in 1 case, mild bladder spasm in 10 cases, and no bladder spasm occurred in 32 cases; no postoperative bleeding occurred in 43 cases; there was no postoperative infection in 40 cases, but 3 cases had postoperative infection; there was no secondary indwelling catheter in 43 cases. In the control group, 38 cases had no bladder perforation, but 4 cases had bladder perforation during operation; muscular tissue was found in 32 specimens, but was absent in 10; there were 4 cases of severe bladder spasm, 19 cases of mild bladder spasm, and 19 cases of no bladder spasm; no postoperative bleeding occurred in 38 cases, but 4 cases did; 31 cases had no postoperative infection, while 11 cases had postoperative infection; there were 37 cases without secondary catheter indwelling, while 5 cases with secondary catheter indwelling. All the above data were statistically different (P < 0.05), and the observation group was better than the control group. The observation group had no unplanned reoperation, while one patient in control group underwent unplanned reoperation because of postoperative bleeding.Conclusion Intraoperative negative pressure suction can significantly improve the safety of transurethral bladder tumor resection for non-muscular invasive bladder cancer. -
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表 1 两组患者术前资料比较
X±S，M(P25，P75) 项目 观察组(43例) 对照组(42例) t/χ2/Z P 年龄/岁 65.23±6.13 65.93±5.75 -0.594 0.591 性别(男/女)/例 33/10 31/11 0.098 0.754 肿瘤最大直径/cm 2.44±0.71 2.69±0.69 -1.624 0.108 肿瘤个数(单发/2个/3个)/例 31/10/2 31/8/3 0.411 0.814 残余尿/mL 10(0，15) 10(0，15) -0.152 0.879 
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表 2 两组患者术中及术后指标比较
M(P25，P75) 项目 观察组(43例) 对照组(42例) χ2/Z P 手术时间/min 15(14.00，17.00) 24(19.75，25.00) -6.922 < 0.001 膀胱穿孔(无/有)/例 43/0 38/4 4.297 0.038 肌层组织(有/无)/例 40/3 32/10 4.647 0.031 膀胱痉挛(重度/轻度/无)/例 1/10/32 4/19/19 -2.792 0.005 术后出血(无/有)/例 43/0 38/4 4.297 0.038 术后感染(无/有)/例 40/3 31/11 5.701 0.017 二次留置尿管(无/有)/例 43/0 37/5 5.439 0.020 非计划再次手术(无/有)/例 43/0 41/1 1.036 0.309
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