Delacroix Scott E, Winters J C
Department of Urology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
Clin Colon Rectal Surg. 2010 Jun;23(2):113-8. doi: 10.1055/s-0030-1254298.
Extirpative procedures for advanced colorectal cancers can involve multivisceral pelvic resections. In patients without evidence of distant metastatic disease, a reasonable therapeutic effect can be expected when negative surgical margins are obtained. For patients with bladder involvement, the decision to perform a bladder-sparing procedure or a total pelvic exenteration will be based on the extent of the primary lesion as well as patient characteristics. In this article, the authors describe bladder-sparing techniques with and without enterocystoplasty as well as options for urinary diversion in patients requiring total pelvic exenteration. Contraindications and clinical decision making regarding bladder reconstruction or replacement are discussed.
晚期结直肠癌的根治性手术可能涉及多脏器盆腔切除术。对于没有远处转移疾病证据的患者，若能获得阴性手术切缘，则有望获得合理的治疗效果。对于膀胱受累的患者，决定实施保留膀胱手术还是全盆腔脏器切除术将基于原发病变的范围以及患者特征。在本文中，作者描述了有无肠膀胱扩大术的保留膀胱技术，以及全盆腔脏器切除患者的尿流改道选择。还讨论了膀胱重建或替代的禁忌证及临床决策。
