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首页> 外文期刊>Urology >Narrow Band Imaging Cystoscopy and Bipolar Plasma Vaporization for Large Nonmuscle-invasive Bladder Tumors-Results of a Prospective, Randomized Comparison to the Standard Approach
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Narrow Band Imaging Cystoscopy and Bipolar Plasma Vaporization for Large Nonmuscle-invasive Bladder Tumors-Results of a Prospective, Randomized Comparison to the Standard Approach

机译：大型非肌肉浸润性膀胱肿瘤的窄带成像膀胱镜检查和双极血浆汽化-与标准方法进行前瞻性，随机比较的结果

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OBJECTIVE:To evaluate the efficacy of narrow band imaging (NBI) cystoscopy associated with bipolar plasma vaporization (BPV) in cases of large nonmuscle-invasive bladder tumors (NMIBTs) compared with white light cystoscopy (WLC) and monopolar transurethral resection of bladder tumors (TURBTs).METHODS:A total of 220 cases with >=1 bladder tumor >3 cm determined by abdominal ultrasonography,computed tomography, and flexible WLC were included in the present trial. The patients in the first arm underwent WLC and NBI cystoscopy followed by BPV, and the patients in the second arm underwent only WLC and TURBT. The patients with NMIBTs underwent standard repeat TUR at 4 weeks and follow-up urinary cytology and WLC at 3, 6, 9, and 12 months. RESULTS:The carcinoma in situ, Stage pTa, and overall NMIBT detection rates were significantly improved for NBI compared with WLC. BPV provided lower obturator nerve stimulation and bladder wall perforation rates and significantly reduced the mean hemoglobin decrease, cathe-terization period, and hospital stay compared with TURBT. The repeat TUR overall and primary site residual tumor rates were significantly decreased in the NBI-BPV group (6.3% vs 17.5% and 4.2% vs 13.4%, respectively). The overall and other site 1-year recurrence rates were significantly reduced in the NBI-BPV series (7.9% vs 17.8% and 3.4% vs 12.2%, respectively).CONCLUSION:NBI cystoscopy significantly improved the diagnostic accuracy in cases of large NMIBTs, and BPV emphasized superior efficacy and safety compared with TURBT. This combined approach provided a lower residual tumor rate at repeat TUR and a reduced 1-year recurrence rate.
机译：目的：与白光膀胱镜检查（WLC）和单极经尿道膀胱肿瘤切除术相比，评估窄带成像（NBI）膀胱镜检查与双极血浆汽化（BPV）相关的大型非肌肉浸润性膀胱肿瘤（NMIBTs）的疗效（方法：本研究共纳入220例经腹部超声检查，计算机断层扫描和柔性WLC确定的> = 1膀胱肿瘤> 3 cm的病例。第一臂的患者接受了WLC和NBI膀胱镜检查，随后进行了BPV，而第二臂的患者仅接受了WLC和TURBT。患有NMIBTs的患者在4周时进行标准TUR，在3、6、9和12个月时进行随访尿细胞学检查和WLC。结果：与WLC相比，NBI的原位癌，pTa期和NMIBT总体检出率显着提高。与TURBT相比，BPV提供了较低的闭孔神经刺激和膀胱壁穿孔率，并显着降低了平均血红蛋白减少，导管插入时间和住院时间。在NBI-BPV组中，重复性TUR总体和原发部位残余肿瘤发生率显着降低（分别为6.3％对17.5％和4.2％对13.4％）。 NBI-BPV系列的总体和其他部位1年复发率显着降低（分别为7.9％比17.8％和3.4％比12.2％）。与BURBT相比，BPV强调了卓越的功效和安全性。这种组合方法在重复TUR时具有较低的残留肿瘤发生率，并降低了1年复发率。

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