Zellner M, Riedl R
Urologische Klinik, Klinikum Passauer Wolf, Bad Griesbach.
Urologe A. 2005 Jan;44(1):46-50. doi: 10.1007/s00120-004-0744-x.
Radical cystectomy in combination with different types of continent and incontinent urinary diversion is an integral part of the treatment concept for bladder tumors. Although in principle this operation does not cause disability in general, it represents a potentially massive encroachment on the physical and psychological integrity of the individual. The term "quality of life" appears with increasing frequency in modern concepts of evidence-based medicine. Also recognition of the subjective assessment of treatment by those affected in comparison to the "objective" view of qualified doctors and functionaries has become more relevant.Nevertheless, few studies have analyzed the "quality of life" after cystectomy. In addition, methodological factors hinder comparability. Only a few authors have used validated measuring instruments that allow comparison of the data. Low case numbers limit the statistical significance. Besides typical postoperative consequences and their effect on quality of life, potential influences on the pre- and postoperative assessment in the intraindividual course are discussed. The authors argue in favor of postoperative urological rehabilitation in qualified urological centers to optimize physical and psychological coping with the new life situation of "cystectomy with urinary diversion."
根治性膀胱切除术联合不同类型的可控性和不可控性尿流改道术是膀胱肿瘤治疗理念中不可或缺的一部分。虽然原则上该手术一般不会导致残疾，但它对个体的身体和心理完整性构成了潜在的巨大侵犯。“生活质量”一词在现代循证医学概念中出现的频率越来越高。与合格医生和工作人员的“客观”观点相比，患者对治疗的主观评估也变得更加重要。然而，很少有研究分析膀胱切除术后的“生活质量”。此外，方法学因素阻碍了可比性。只有少数作者使用了经过验证的测量工具来比较数据。病例数少限制了统计显著性。除了典型的术后后果及其对生活质量的影响外，还讨论了个体病程中对术前和术后评估的潜在影响。作者主张在合格的泌尿外科中心进行术后泌尿外科康复，以优化身体和心理对“膀胱切除并尿流改道”新生活状况的应对。
