Evaluation Of Clinical Application Of Plasma L-type Bipolar Electrode Block Resection In Non-muscular Invasive Bladdercancer

Objective:To evaluate the therapeutic effect of bulk resection of non-muscular invasive bladder cancer(NMIBC)with plasma L-shapedbipolarelectrode..Methods:Atotal of 54 patients with bladder cancer(Bladdercancer,BC)in our hospital from January 2019 to December 2021 were retrospectively analyzed.All patients were pathologically diagnosed as non-myometrial invasive bladder cancer.The patients were divided into two groups according to the mode of operation.In the L-type electrode group,there were 28 patients(23 males and 5 females).There were 31 resected tumors,25 solitary tumors and 3 multiple tumors.12 bladder tumors grew in the lateral wall of the bladder and 16 tumors grew in the posterior wall and other parts of the bladder.The average size of the tumor was 1.9 ±0.7 cm.The age ranged from 30 to 80 years old,with an average of 62.46 ±10.36 years.There were 26 cases of transurethral resection of bladder tumor(TURBT)with traditional electrode.There were 21 males and 5 females,aged from 35 to 79 years old,with an average of 63.34 ±11.46 years.There were 28 tumors,24 solitary tumors,2 multiple tumors,11 bladder tumors growing in the lateral wall of the bladder and 15 tumors growing in the posterior wall of the bladder and other sites.The average size of the tumor was 1.7 ±0.6 cm.The incidence of obturator nerve reflex(obturatornervereflex,ONR),intraoperative blood loss,average operation time,postoperative catheterization time,hospital stay,muscle detection rate of pathological specimens,postoperative 3 months,postoperative 6 months and 1 year postoperative recurrence rate were comparedbetween the twogroups.Results:All 54 cases were operated by the same experienced chief physician in our hospital.The incidence of ONR was 0.00% in the L-type electrode group and 19.23% in the traditional electrode group,and the difference between the two groups was statistically significant(p < 0.05).The intraoperative blood loss in the L-type electrode group was 27.13(18.93,37.33)ml,while that in the traditional electrode group was 59.88(39.05,75.39)ml.The intraoperative blood loss in the L-type electrode group was less than that in the traditional electrode group,and the difference was statistically significant(p < 0.001).The average operating time of the L-type electrode group was33.85±11.09 min,and that of the traditional electrode group was 41.73±11.98 min.The average operating time of the L-type electrode group was shorter than that of the traditional electrode group,and the difference was statistically significant(p < 0.05).The postoperative catheterization time of the L-type electrode group was 19.00(18.00,22.00)h,and that of the traditional electrode group was48.00(24.00,49.00)h.The postoperative catheterization time of the L-type electrode group was shorter than that of the traditional electrode group,and the difference was statistically significant(p <0.001).Detrusor muscle of bladder was detected in pathological specimens of all patients in L-type electrode group,and the detection rate was 100%.There were 22 cases with and 4 cases without muscle layer detected in the traditional electrode group,with a detection rate of 84.62%.The detection rate of muscle in the L-type electrode group was higher than that in the traditional electrode group,and the difference between the two groups was statistically significant(p < 0.05).One year after surgery,there was no recurrence in the L-type electrode group(0.00%),while there were 6 cases(23.08%)in the traditional electrode group.The recurrence rate in the L-type electrode group was lower than that in the traditional electrode group,and the difference was statistically significant(p <0.05).There were no significant differences in hospital stay,recurrence rate 3 months after surgery and recurrencerate 6 months after surgeryamong different surgical methods(p > 0.05).Conclusion:1.Plasma L-shaped bipolar electrode can reduce the incidence of ONR,reduce operative complications,have higher surgical safety,less trauma,faster recovery,shorter operation time,less bleeding,shorter postoperative catheterization time and less psychological and economic pressure on patients.2.The muscle detection rate of plasma L-type bipolar electrode is high,which is beneficial to pathological staging and further diagnosis and treatment.3.Plasma L-shaped bipolar electrode can reduce the recurrence rate of bladder tumor in a short time.