关键词: 膀胱肿瘤, 非肌层浸润性膀胱癌, 激光切除术, 电切术, 应激

Abstract: Objective To investigate the efficacy of cystoscopic laser resection and electric resection of bladder tumor in 166 patients with non muscular invasive bladder cancer (NMIBC).Methods NMIBC patients admitted to our hospital from July 2013 to June 2015 were selected as the research objects,and were randomly divided into laser group and electro-resection group，83 cases in each group.The laser group was treated with laser resection of bladder tumor,and the electro-resection group was treated with electro-resection of bladder tumor.The levels of oxidative stress factors, surgical indicators, postoperative complications, tumor recurrence rate and tumor-free survival were compared between the two groups 1 day before surgery (T0), 1 day after surgery (T1), 3 days after surgery (T2) and 7 days after surgery (T3).Results  After treatment,compared with the electrical group[(30.87±3.92)min,(23.56±4.23)h,(7.13±1.24)(27.86±4.35)ml],the operation time[(23.63±2.78)min],hematuria duration[(21.16±5.37)h] and catheter indwelling time[(4.97±0.89)d] and the intraoperative blood loss[(20.91±3.21)ml] in the laser group were shorter(P<0.05).The incidence of postoperative bladder perforation,obturator nerve reflex and the total incidence of postoperative complications in the laser group were 0， 0， 6.02%,respectively,which were lower than the electrical group(7.23%,9.64%,21.10%)(P<0.05).Compared with the electrical group,the laser group of Glutathione peroxidase(GSH-Px) and superoxide dismutase(SOD) were higher at T1,T2 and T3[GSH-Px：(42.84±2.98)pg/ml、(55.61±3.79)pg/ml、(74.16±5.04)pg/ml；SOD：(97.78±8.24)μmol/L、(122.57±10.03)μmol/L、(154.24±11.34)μmol/L],while malondialdehyde(MDA) was lower at T1,T2 and T3[(14.33±0.93)mmol/ml、（10.22±0.85）mmol/ml、（5.25±0.57)mmol/ml](P<0.05).During the 5-year follow-up,there were 10 cases of recurrence in the laser group and 17 cases in the electro-resection group,and there was no significant difference in the 5-year postoperative total recurrence rate(12.05% vs.20.48%) and cumulative disease-free survival rate[(87.95±3.57）% vs（79.52±4.43)%] between the two groups(P>0.05).Conclusion Compared with electro-resection of bladder tumor,laser resection is safe,efficient and reliable,with shorter operation time,lower complication rate and less stress response.

Key words: bladder tumor, non-muscular invasive bladder cancer, laser resection, electro-resection, stress