Suppr超能文献

膀胱挛缩:卡介苗膀胱内灌注并发症的综述

Bladder contracture: review for intravesical bacillus Calmette-Guerin complication.

作者信息

Hameed A, Sezian N, Thwaini A

机构信息

The James Paget University Hospital, United Kingdom.

出版信息

Can J Urol. 2007 Dec;14(6):3745-9.

Abstract

INTRODUCTION

We are reporting a case of bladder contracture post intravesical bacillus Calmette-Guerin (BCG) therapy; to our knowledge only two cases were reported. We present the clinical history/presentation investigation and the outcome of the treatment. Approximately 75%-85% of patients with bladder cancer present with disease confined to the mucosa (stage Ta-CIS) or submucosa (stage T1). The management of non-muscle invasive bladder cancer has become more complex with regard to initial investigation, treatment and follow-up. In high-grade tumors, BCG therapy has proven to be superior to intravesical chemotherapy. BCG therapy prevents, or at least delays, tumor progression.

METHODS AND RESULTS

A case of high grade superficial bladder caner treated with intravesical BCG which has successfully cleared her bladder cancer nevertheless has lead to bladder contracture for which case she may need bladder reconstruction/augmentation surgery if she remained disease free added to her psychological and social effects on her life.

CONCLUSION

Although BCG is considered a very effective treatment; consensus exists that not every patient with superficial bladder cancer should be treated with BCG due to its increased risk of toxicity. Ultimately, the choice of treatment will depend upon the patient's risk of recurrence and progression. Assuming that maintenance therapy is necessary for optimal efficacy, the issue of BCG toxicity becomes more relevant. Due to the more pronounced side effects of BCG compared to intravesical chemotherapy, reluctance still exists about BCG use. However, with increased experience in applying BCG, the side effects now appear to be less prominent and few. Serious side effects are encountered in less than 5% of patients and this case carries one of the rarest, yet drastic, side effects of intravesical BCG.

摘要

引言

我们报告一例膀胱内卡介苗(BCG)治疗后膀胱挛缩的病例;据我们所知,此前仅报告过两例。我们介绍了该病例的临床病史/表现、检查及治疗结果。大约75%-85%的膀胱癌患者疾病局限于黏膜(Ta-CIS期)或黏膜下层(T1期)。非肌层浸润性膀胱癌在初始检查、治疗及随访方面的管理变得更加复杂。在高级别肿瘤中,BCG治疗已被证明优于膀胱内化疗。BCG治疗可预防或至少延缓肿瘤进展。

方法与结果

一例高级别浅表性膀胱癌患者接受膀胱内BCG治疗,成功清除了膀胱癌,但导致了膀胱挛缩。如果她保持无病状态,可能需要进行膀胱重建/扩大手术,这也给她的心理和生活带来了社会影响。

结论

尽管BCG被认为是一种非常有效的治疗方法;但由于其毒性风险增加,目前存在一种共识,即并非每个浅表性膀胱癌患者都应接受BCG治疗。最终,治疗方案的选择将取决于患者复发和进展的风险。假设维持治疗对于最佳疗效是必要的,BCG毒性问题就变得更加重要。由于与膀胱内化疗相比,BCG的副作用更明显,人们对BCG的使用仍存在顾虑。然而,随着应用BCG经验的增加,现在副作用似乎不那么突出且较少。不到5%的患者会出现严重副作用,而该病例呈现出膀胱内BCG最罕见但严重的副作用之一。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验