经尿道膀胱肿瘤电切术同期经尿道前列腺电切术治疗非浸润性膀胱癌伴良性前列腺增生的安全性及有效性研究

doi:10.3969/j.issn.1005-6483.2021.09.021

摘要/Abstract

摘要： 目的探讨经尿道膀胱肿瘤电切术（TURBT）同期行经尿道前列腺电切术（TURP）治疗非浸润性膀胱癌（NMIBC）伴良性前列腺增生（BPH）的安全性及有效性。
方法 NMIBC伴良性BPH病人120例，根据术式分为两组：观察组53例，行TURBT同期TURP治疗，对照组67例，单纯行TURBT治疗。比较两组围手术期情况，术前及术后6个月评价残余尿量（RUV）、最大尿流率（MFR）、国际前列腺症状评分（IPSS）、肿瘤病人生活质量评分（QOL），术后随访统计肿瘤复发、转移及进展情况。
结果观察组手术时间（125.44±25.43）分钟，术中出血量（110.21±11.84）ml，膀胱冲洗时间（30.21±6.85）小时，尿管留置时间（5.62±1.13）天，住院时间（12.17±2.33）天，对照组分别为（76.85±21.03）分钟、（76.85±9.43）ml、（22.79±5.61）小时、（4.19±0.92）天、（9.01±2.14）天，两组比较差异有统计学意义（P<0.05）。术后6个月，观察组的MFR为（21.23±2.27）ml/s，明显高于对照组的（9.79±1.78）ml/s，差异有统计学意义（P<0.05）；观察组的RUV（15.82±2.33）ml、IPSS评分（5.14±1.02）分、QOL评分（1.39±0.41）分，对照组分别为（70.21±15.94）ml、(20.11±3.48)分、（3.25±0.72）分，两组比较差异有统计学意义（P<0.05）。观察组术后并发症发生率为15.09%，对照组为5.97%，两组比较差异无统计学意义（P>0.05）。观察组的复发率24.53%、转移率1.89%、肿瘤进展率11.32%，对照组分别为20.90%、0和7.46%，两组比较差异无统计学意义（P>0.05）。
结论 TURBT同期行TURP治疗NMIBC伴良性BPH安全有效，不增加肿瘤复发、转移及进展风险，且可改善病人的BPH症状及生存质量。

关键词: 非浸润性膀胱癌, 良性前列腺增生, 经尿道膀胱肿瘤电切术, 经尿道前列腺电切术, 安全性, 预后

Abstract: Objective To investigate the safety and effectiveness of simultaneous transurethral resection of bladder tumor(TURBT) and transurethral resection of prostate(TURP) in treatment of non-muscle-invasive bladder cancer(NMIBC) patients complicated by benign prostatic hyperplasia(BPH).
Methods The clinical data of 120 cases of NMIBC patients complicated by BPH were analyzed retrospectively.53 patients underwent simultaneous TURBT and TURP as the observation group,and the remaining 67 patients underwent TURBT alone as the control group.The perioperative conditions of the two groups were compared.Residual urine volume(RUV),maximum urine flow rate(MFR),international prostate symptom score(IPSS),and quality of life(QOL) score before and 6 months after surgery were evaluated.The tumor recurrence,metastasis and progress were followed up and counted.
Results The operation time(125.44±25.43)min,intraoperative blood loss(110.21±11.84)ml,postoperative bladder irrigation time(30.21±6.85)h,catheter indwelling time(5.62±1.13)d and hospital stay(12.17±2.33)d,which were higher than those of the control group [(76.85±21.03) min,(76.85±9.43)ml,(22.79±5.61)h、(4.19±0.92)d,(9.01±2.14)d],the differences were statistically significant(P<0.05).At 6 months after surgery,the MFR of the observation group[(21.23±2.27)ml/s] was higher than the control group[(9.79±1.78)ml/s],the RUV(15.82±2.33)ml,IPSS score(5.14±1.02),QOL score(1.39±0.41) of the observation group were lower than the control group[(70.21±15.94)ml,(20.11±3.48),(3.25±0.72)](P<0.05).The incidence of postoperative complications was 15.09% in the observation group,which was no significant difference with 5.97% in the control group(P>0.05). The recurrence rate(24.53%),metastasis rate(1.89%),and tumor progression rate(11.32%) of the observation group were no statistically significant difference with the control group(24.53%,1.89%,11.32%)(P>0.05).
Conclusion Simultaneous TURBT and TURP is safe and effective for NMIBC with BPH,which can improve the BPH symptoms and quality of life of patients,and does not increase the risk of tumor recurrence,metastasis and progression.

Key words: non-invasive bladder cancer, benign prostatic hyperplasia, transurethral resection of bladder tumor, transurethral resection of prostate; , safety, prognosis

姜小琴李惠珍. 经尿道膀胱肿瘤电切术同期经尿道前列腺电切术治疗非浸润性膀胱癌伴良性前列腺增生的安全性及有效性研究[J]. 临床外科杂志, 2021, 29(9): 872-875.

JIANG Xiaoqin, LI Huizhen.. Safety and effectiveness study of simultaneous TURBT and TURP in treatment of non-muscle-invasive bladder cancer patients complicated by benign prostatic hyperplasia[J]. JOURNAL OF CLINICAL SURGERY, 2021, 29(9): 872-875.

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