經尿道膀胱腫瘤切除術後使用蒸餾水膀胱灌洗相比於生理食鹽水無法預防腫瘤復發或進展
賴韋宏、張恩承、周詠欽、林昌德、沈正煌、鄭明進、陳丕哲
嘉義基督教醫院 外科部 泌尿科
Continuous bladder irrigation with distilled water following transurethral resection of bladder tumors in patients with
non-muscle invasive bladder cancer does not prevent recurrence or  progression compared with normal saline
Ian-Seng Cheong, Wei-hong Lai, Ming-Chin Cheng, Yeong-Chin Jou, Cheng-Huang Shen, Chang-Te Lin, Pi-Che Chen
Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan

Purpose: Continuous bladder irrigation (CBI) has been examined as an alternative treatment to intravesical chemotherapy. In this study we sought to compare the rates of recurrence and/or progression in patients with NMIBC who were treated with CBI using either distilled water or normal saline after TURBT.

Materials and Methods: We retrospectively reviewed records of patients with NMIBC at our institution in 2014–2018. Perioperative use of MMC (40 mg in 20 mL), CBI with saline or distilled water were recorded. Primary outcome was time to recurrence or progression. Descriptive statistics, chi-squared analysis, Kaplan-Meier survival analysis, and Cox multivariable regression analyses were performed.

Results: 442 patients met inclusion criteria. Twenty-five (5.6%) patients received CBI with normal saline, 417 (94.4%) received CBI with distilled water. On survival analysis, there was no statistic significance in DFS compared with normal saline group and distilled water group (p = 0.71). On multivariable analysis, high grade disease was associated with increased risk of recurrence or progression (HR 2.77, 95% CI: 1.28–6.01), whereas MMC (HR 0.43, 95% CI: 0.25–0.75) were associated with decreased risk.

Conclusions: Choosing either normal saline or distilled water as fluid used in CBI after TURBT does not affect progression free survival.