Schilling David, Horstmann Marcus, Nagele Udo, Sievert Karl-Dietrich, Stenzl Arnulf
Department of Urology, University Hospital Tübingen, Tübingen, Germany.
BJU Int. 2008 Nov;102(9 Pt B):1289-95. doi: 10.1111/j.1464-410X.2008.07972.x.
The technique for radical cystectomy in women is described, with special consideration given to the pelvic anatomy, and the urethra- and nerve-sparing approach in female patients. Advances in understanding female pelvic anatomy, following detailed animal, cadaveric and clinical studies, merged to give a better intraoperative identification of the sphincteric apparatus and neurovascular structures. Respecting the oncological premises, cystectomy in female patients can be done with a nerve-sparing technique. In rare cases the entire inner genitalia, including the anterior vaginal wall, can be preserved, which might lead to improved functional results with greater patient satisfaction. However, the oncological result should never be endangered by organ preservation.
本文描述了女性根治性膀胱切除术的技术，特别考虑了盆腔解剖结构以及女性患者的保留尿道和神经的手术方法。在对动物、尸体和临床进行详细研究之后，对女性盆腔解剖结构的认识取得了进展，这使得术中能够更好地识别括约肌装置和神经血管结构。在遵循肿瘤学原则的前提下，女性患者的膀胱切除术可以采用保留神经的技术。在极少数情况下，可以保留包括阴道前壁在内的整个内生殖器，这可能会带来更好的功能结果，提高患者满意度。然而，绝不能因保留器官而危及肿瘤学治疗效果。
