The application of self-made "forceps lifting" auxiliary device for en-bloc resection of bladder tumor through urethra in the treatment of non-muscular invasive bladder cancer

doi:10.3877/cma.j.issn.1674-3253.2024.01.007

Abstract

Abstract:

Objective

To explore the clinical effect of self-made "forceps lifting" auxiliary device for transurethral bladder tumor en-bloc resection in the treatment of non-muscle invasive bladder cancer.

Methods

The clinical data of 64 cases of non-muscle invasive bladder cancer in Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital from March 2021 to January 2023 were retrospectively analyzed. They were divided into general group and improved group, 32 cases in each group. For enucleation, the improved group used a self-made "forceps lifting" auxiliary device for transurethral en-bloc enucleation of bladder tumors with holmium laser, the general group underwent traditional transurethral holmium laser en-bloc enucleation of bladder tumors. The operation time, intraoperative hemoglobin decrease, surgical complications and tumor recurrence were compared between the two groups.

Results

The operations of all patients went smoothly. The hemoglobin in the improved group decreased by (5±3) g/L, the probability of bladder perforation was 0%(0/32), the tumor recurrence rate in situ was 3.13%(1/32), and the hemoglobin in the general group decreased (6±3) g/L, the probability of bladder perforation was 9.38%(3/32), and the tumor recurrence rate in situ was 12.5%(4/32), there was no significant difference between the two groups (P>0.05). The operation time of the improved group was (19±7) min, shorter than the general group [(25±8) min](P=0.004); the number of people with muscular layer tissue in the tumor base of the improved group accounted for 93.75%, which was significantly more than that of the general group, which was 40.63% (P<0.001).

Conclusions

The holmium laser enuclear enucleation of transurethral bladder tumors treated with self-made "forceps lifting" auxiliary device has the same fewer surgical complications as general en bloc holmium laser enucleation of transurethral bladder tumors, and is safe. Because it can clearly and stably expose the tumor base, the operation time is shorter, and more muscle tissue at the base of the tumor can be obtained, which is conducive to tumor pathological detection. The technology is self-made with existing equipment, easy to operate, and worthy of clinical promotion.

Key words: Bladder tumor, Instrumental assistance, En-bloc resection of bladder tumor

Weifeng Wang, Jun Zhang, Jiansheng Wan, Siming Liu, Yuan Zou, Shaoqiu Zheng, Jidong Hao, Guoqiang Liao, Hua Gong, Lei OuYang. The application of self-made "forceps lifting" auxiliary device for en-bloc resection of bladder tumor through urethra in the treatment of non-muscular invasive bladder cancer[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(01): 36-40.

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References 28

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组别	例数	性别(例)		年龄[岁，(±s)]	肿瘤数目(例)		最大肿瘤直径[cm，(±s)]	肿瘤位置(例)
组别	例数	男	女	年龄[岁，(±s)]	单发	多发	最大肿瘤直径[cm，(±s)]	部分及全部侧壁	三角区及后壁
普通组	32	24	8	66±8	22	10	2.3±1.1	7	25
改良组	32	25	7	69±7	20	12	2.4±1.1	9	23
统计值		χ²=0.087		t=0.375	χ²=0.277		t=0.603	χ²=0.333
P值		0.768		0.625	0.599		0.209	0.564

组别	例数	性别(例)		年龄[岁，(±s)]	肿瘤数目(例)		最大肿瘤直径[cm，(±s)]	肿瘤位置(例)
组别	例数	男	女	年龄[岁，(±s)]	单发	多发	最大肿瘤直径[cm，(±s)]	部分及全部侧壁	三角区及后壁
普通组	32	24	8	66±8	22	10	2.3±1.1	7	25
改良组	32	25	7	69±7	20	12	2.4±1.1	9	23
统计值		χ²=0.087		t=0.375	χ²=0.277		t=0.603	χ²=0.333
P值		0.768		0.625	0.599		0.209	0.564

组别	例数	手术时间[min，(±s)]	血红蛋白下降值[g/L，(±s)]	膀胱穿孔率[例(%)]		肿瘤浅肌层完整情况[例(%)]	肿瘤原位复发率[例(%)]
组别	例数	手术时间[min，(±s)]	血红蛋白下降值[g/L，(±s)]	无	有	肿瘤浅肌层完整情况[例(%)]	无	有
普通组	32	25±8	6±3	29（90.62）	3（9.38）	13（40.63）	28（87.50）	4（12.50）
改良组	32	19±7	5±3	32（100.00）	0（0.00）	30（93.75）	31（96.87）	1（3.13）
统计值		t=8.242	t=2.148	-		χ²=40.966	-
P值		0.004	0.143	0.238^a		<0.001	0.355^a

组别	例数	手术时间[min，(±s)]	血红蛋白下降值[g/L，(±s)]	膀胱穿孔率[例(%)]		肿瘤浅肌层完整情况[例(%)]	肿瘤原位复发率[例(%)]
组别	例数	手术时间[min，(±s)]	血红蛋白下降值[g/L，(±s)]	无	有	肿瘤浅肌层完整情况[例(%)]	无	有
普通组	32	25±8	6±3	29（90.62）	3（9.38）	13（40.63）	28（87.50）	4（12.50）
改良组	32	19±7	5±3	32（100.00）	0（0.00）	30（93.75）	31（96.87）	1（3.13）
统计值		t=8.242	t=2.148	-		χ²=40.966	-
P值		0.004	0.143	0.238^a		<0.001	0.355^a

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