能源来源与结果的关联 en bloc TURB:随机试验的二次分析
Stefano Mancon1,2,3, Francesco Soria4, Rodolfo Hurle3
1Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
World journal of urology
|March 27, 2025
概括
与单极或激光技术相比,膀瘤双极分离切除 (b-ERBT) 提供了更好的结果,降低了复发率. 进一步的研究将评估ERBT中不同能源的长期瘤学结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 手术技术 手术技术
背景情况:
- 膀瘤 En-bloc 顺尿切除术 (ERBT) 是一种关键的外科手术技术.
- 对ERBT的不同能源的评估对于优化患者的治疗结果至关重要.
研究的目的:
- 为了比较ERBT的单极 (m-ERBT),双极 (b-ERBT) 和激光 (l-ERBT) 能源的周围手术疗效.
- 评估不同ERBT能源模式的病理样本质量和临床结果.
主要方法:
- 一项前性随机研究 (NCT03718754) 的子分析,涉及188名患者和237名膀瘤.
- 患者接受了ERBT,使用m-ERBT,b-ERBT或l-ERBT.
- 终点包括detrusor肌肉的存在,手术时间,切除边缘,复发率和并发症.
主要成果:
- 在80.6%的标本中,detrusor肌肉存在,而能量来源之间没有显著差异.
- b-ERBT与负侧切除边缘相关 (OR 2.81,p=0.04).
- 在对混因素进行调整后,b-ERBT显著降低了局部复发率 (HR 0.24,p=0.002).
结论:
- 虽然经手术后的结果在不同能源中是可比的,但b-ERBT显示了局部复发的显著减少.
- 需要进一步的研究来评估各种ERBT能源模式的长期瘤结果.
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