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女性膀胱癌膀胱切除术系列回顾:并发症与生活质量

Review of a series of cystectomies in women for bladder cancer:Complications and quality of life.

作者信息

Fuentes J, Ramos E, Truan D, Portillo J A, Campos-Juanatey F, Gala L, Meidavilla E, Dominguez M, Gutierrez J L

机构信息

Servicio de Urologia.Complejo Hospitalario Universitario Marques de Valdecilla.Santander.Cantabria.Spain.

出版信息

Arch Esp Urol. 2014 May;67(4):303-12.

PMID:24892391
Abstract

OBJECTIVES

To analyze the complications and quality of life after cystectomies performed in women with bladder cancer at our hospital.

METHODS

Descriptive analysis of demographic data and early/late complications of cystectomies and urinary diversions performed in women at our hospital between 1990-2010. We also assessed quality of life using the Functional Assessment of Cancer Therapy-Bladder Cancer (ACT-BL) questionnaire and a comparison was drawn between groups of clinical variables.

RESULTS

Out of 265 cystectomies, 25 (10%) were performed in women. The predominant urinary diversion was ureterosigmoidostomy (60%), followed by cutaneous ureterostomy (16%), orthotopic ileal neo-bladder Studer pouch (12%), ileal conduit (10%) and permanent nephrostomy (4%). Mean age was 55.75 years. The most commonly occurring early complications were prolonged ileus (20%) and urinary fistula (20%). Late complications included hydronephrosis (32%) and pyelonephritis (32%). The results of quality of life questionnaires were very similar for the different types of urinary diversions, with a mean score of 104.5 out of 156 points.

CONCLUSIONS

Radical cystectomy is a high-risk procedure associated with many complications. In women, ureterosigmoidostomy may be a good choice for urinary diversion in selected patients, with a quality of life very similar to those with different urinary diversions.

摘要

目的

分析我院对膀胱癌女性患者行膀胱切除术后的并发症及生活质量。

方法

对我院1990年至2010年间对女性患者进行膀胱切除术及尿流改道的人口统计学数据和早期/晚期并发症进行描述性分析。我们还使用癌症治疗功能评估-膀胱癌(ACT-BL)问卷评估生活质量,并对临床变量组进行比较。

结果

在265例膀胱切除术中,25例(10%)为女性患者。主要的尿流改道方式是输尿管乙状结肠吻合术(60%),其次是皮肤输尿管造口术(16%)、原位回肠新膀胱Studer囊袋术(12%)、回肠膀胱术(10%)和永久性肾造瘘术(4%)。平均年龄为55.75岁。最常见的早期并发症是肠梗阻延长(20%)和尿瘘(20%)。晚期并发症包括肾积水(32%)和肾盂肾炎(32%)。不同类型尿流改道的生活质量问卷结果非常相似,平均得分为156分中的104.5分。

结论

根治性膀胱切除术是一种高风险手术,伴有许多并发症。对于女性患者,输尿管乙状结肠吻合术可能是某些特定患者尿流改道的一个不错选择,其生活质量与采用不同尿流改道方式的患者非常相似。

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