Abstract：Objective To investigate the efficacy and safety of transurethral endoscopic submucosal dissection (BT-ESD) with Hybrid-knife in the treatment of patients with non muscular invasive bladder cancer (NMIBC), and to analyze the possible factors affecting the efficacy of this operation.Methods From September 2014 to August 2016, 147 patients with NMIBC who were treated in Sun Yat-sen memorial hospital of Sun Yat-sen university, Shaanxi provincial people's hospital, Tongji hospital affiliated to Tongji medical college of Huazhong university of science and technology, general hospital of the Chinese people's liberation army, the first hospital of Ningbo and Yijishan hospital of southern Anhui medical college were selected. The possible factors affecting the curative effect of surgery were evaluated by calculating the independent influencing factors such as incomplete resection and tumor recurrence.Results After 1-year follow-up, all cases achieved radical resection, and the recurrence probability was 6.80% (10/147). There were no deaths. Univariate analysis showed that there was a significant correlation between pathological grade and postoperative recurrence (P=0.005). Further Cox regression analysis showed that pathological grade was an independent influencing factor of postoperative recurrence (P=0.014). Logistic regression analysis showed that obturator nerve reflex (P=0.003), tumor diameter (P=0.006) and operation time (P=0.001) were independent influencing factors of tumor removal. The operation time was an independent influencing factor of catheter retention time (P=0.011).Conclusions BT-ESD with Hybrid-knife is a safe and effective treatment for NMIBC. In the future, long-term, multicenter randomized controlled trials are still needed to test their advantages and disadvantages compared with TURBT.
