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女性膀胱癌保留生殖器的膀胱切除术及其功能结果:24例七年经验

Genital Sparing Cystectomy for Female Bladder Cancer and its Functional Outcome; a Seven Years' Experience with 24 Cases.

作者信息

Roshdy Sameh, Senbel Ahmed, Khater Ashraf, Farouk Omar, Fathi Adel, Hamed EmadEldeen, Denewer Adel

机构信息

Unit of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Gomhoria Street, Mansoura, 35511 Egypt.

出版信息

Indian J Surg Oncol. 2016 Sep;7(3):307-11. doi: 10.1007/s13193-015-0462-4. Epub 2015 Sep 7.

Abstract

The surgical treatment of bladder cancer is the curative treatment especially in early cases. In this study, our aim was to assess the outcome of preservation of internal genital organs in selected females both oncologically and functionally, and to assess the feasibility of technique and its complication. 24 females with clinically and radiologically diagnosed T2 bladder cancer underwent gynecologic-tract sparing cystectomy (GTSC). Age ranged from 45 to 60 years. Patients with diffuse carcinoma-in-situ, those with tumors involving the bladder neck, those with poor general condition and those with preoperative incontinence were excluded. 1 patient, who developed local recurrence after 6 months. One patient lost follow up after 15 months. No recurrence developed in the retained genital organs. The remaining 20 patients remained free of disease. Among women who were eligible for functional evaluation, Daytime and nighttime continence were satisfactory in 21/22 (95.4 %) and in 20/22 (90.9 %) respectively. Chronic urinary retention, pouch-vaginal fistula was not noted. Most of patients showed superior Sexual Function index. Cystectomy with preservation of the internal genital organs is feasible in female with early, solitary or T2 bladder cancer with satisfactory functional and oncologic outcomes with proper case selection.

摘要

膀胱癌的手术治疗是一种根治性治疗方法,尤其是在早期病例中。在本研究中,我们的目的是从肿瘤学和功能方面评估在特定女性患者中保留内生殖器器官的结果,并评估该技术的可行性及其并发症。24例临床和影像学诊断为T2期膀胱癌的女性患者接受了保留生殖道的膀胱切除术(GTSC)。年龄范围为45至60岁。排除弥漫性原位癌患者、肿瘤累及膀胱颈的患者、一般状况较差的患者以及术前存在尿失禁的患者。1例患者在6个月后出现局部复发。1例患者在15个月后失访。保留的生殖器官未出现复发。其余20例患者无疾病复发。在符合功能评估条件的女性中,白天和夜间尿失禁情况分别在21/22(95.4%)和20/22(90.9%)的患者中令人满意。未发现慢性尿潴留、膀胱阴道瘘。大多数患者性功能指数良好。对于早期、孤立性或T2期膀胱癌的女性患者,通过适当的病例选择,保留内生殖器器官的膀胱切除术是可行的,其功能和肿瘤学结果令人满意。

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