[1]田官强,程量,周志豪,等.经尿道激光与电切术治疗非肌层浸润性膀胱癌效果及安全性比较的Meta分析[J].第三军医大学学报,2019,41(14):1387-1396.
 TIAN Guanqiang,CHENG Liang,ZHOU Zhihao,et al.Efficacy and safety of transurethral laser versus transurethral resection for non-muscle invasive bladder urothelial carcinoma: a meta-analysis[J].J Third Mil Med Univ,2019,41(14):1387-1396.
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经尿道激光与电切术治疗非肌层浸润性膀胱癌效果及安全性比较的Meta分析
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第14期
页码:
1387-1396
栏目:
公共卫生与预防医学
出版日期:
2019-07-30

文章信息/Info

Title:
Efficacy and safety of transurethral laser versus transurethral resection for non-muscle invasive bladder urothelial carcinoma: a meta-analysis
作者:
重庆医科大学附属第二医院泌尿外科
Author(s):
TIAN Guanqiang CHENG Liang ZHOU Zhihao CHEN Yanlin LIANG Chang LEI Yusheng FU Tingbo ZHANG Xirong LIANG Peihe

Department of Urology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China

关键词:
膀胱肿瘤激光尿道电切Meta分析
Keywords:
bladder tumor laser transurethral resectionMeta-analysis
分类号:
R699.5;R730.56;R737.14
文献标志码:
A
摘要:

目的 对比分析经尿道激光与经尿道电切手术对非肌层浸润性膀胱尿路上皮癌(non-muscle invasive bladder cancer, NMIBC)的疗效及安全性。方法 在PubMed、Cochrane图书馆、Medline、Embase、Web of science、社会科学引文索引、中国期刊网全文数据库(CNKI)、中国生物医学文献数据库、维普医学数据库、万方数据库中,检索NMIBC使用经尿道激光与经尿道电切手术治疗的随机对照研究、半随机对照研究(队列研究和病例对照研究)文献,并使用RevMan 5.3软件对数据进行荟萃分析。结果 共纳入16篇文献,病例2 570例。对比结果如下:手术时间(MD=-0.70;95%CI: -2.78~1.38;P=0.51)及术后尿道狭窄发生率(OR=0.70;95%CI: 0.24~2.06;P=0.52)差异无统计学意义;术中闭孔神经反射(OR=0.05;95%CI:0.02~0.10;P<0.001)、膀胱穿孔发生率(OR=0.11;95%CI: 0.04~0.29;P<0.001)、术后导尿时间(MD= -1.08;95%CI:-1.46~-0.71;P<0.001)、住院时间(MD= -1.00;95%CI: -1.66~-0.34;P=0.003)、膀胱冲洗(OR=0.21;95%CI: 0.13~0.35;P<0.001)、12个月复发率(OR=0.67;95%CI: 0.48~0.93;P=0.02)及24个月复发率(OR=0.60;95%CI:0.41~0.86;P=0.005)上激光优于电切。结论 经尿道激光手术治疗NMIBC术中并发症(闭孔神经反射、膀胱穿孔)发生率、术后复发率低,恢复较快,较经尿道电切术具有一定优势。

Abstract:

Objective To compare the safety and efficacy of transurethral laser and transurethral resection for treatment of non-muscle invasive bladder cancer (NMIBC). MethodsRandomized controlled trials, cohort studies and case-control studies comparing transurethral laser and transurethral resection of NMIBC were retrieved from PubMed, Medline, Embase, Cochrane Library, Web of Science, Social Science Citation Index, China Journal Full-text Database (CNKI), Chinese Biomedical Literature Database and VIP medical database. RevMan 5.3 software was used for meta-analysis of the data extracted from the eligible studies. ResultsWe retrieved 16 eligible studies involving a total of 2 570 patients from the databases. Meta-analysis of the data from these studies showed no significant difference between the 2 surgical modalities in terms of the operation time (MD=-0.70, 95%CI:  -2.78~1.38, P=0.51) or the occurrence of postoperative urethral stricture (OR=0.70, 95%CI: 0.24~2.06, P=0.52). Compared with transurethral resection, transurethral laser surgery was associated with significantly lower incidences of intraoperative obturator nerve reflex (OR=0.05, 95%CI: 0.02~0.10; P<0.001) and bladder perforation (OR=0.11, 95%CI: 0.04~0.29, P<0.001), shorter postoperative catheterization time (MD=-1.08, 95%CI: -1.46~-0.71, P<0.001) and length of hospital stay (OR=0.05, 95%CI: 0.02~0.10, P<0.001), and lower rates of bladder irrigation (OR=0.21, 95%CI: 0.13~0.35, P<0.001) and postoperative recurrence at 12 months (OR=0.67, 95%CI: 0.48~0.93, P=0.02) and 24 months (OR=0.60, 95%CI: 0.41~0.86, P=0.005). ConclusionTransurethral laser surgery for NMIBC, as compared with transurethral resection, is associated with lower incidences of intraoperative complications (obsessive nerve reflex and bladder perforation), a lower postoperative recurrence rate, and faster postoperative recovery.

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更新日期/Last Update: 2019-07-22