Aminoltejari Khatereh, Black Peter C
Department of Urologic Sciences, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.
Transl Androl Urol. 2020 Dec;9(6):3073-3081. doi: 10.21037/tau.2020.03.23.
Radical cystectomy (RC) with urinary diversion is considered the standard treatment for muscle invasive bladder cancer (MIBC). As one of the most challenging surgical techniques performed by urologists, RC was described many decades ago, and yet patient morbidity rates have remained stagnant over the years. This review outlines the most recent indications and techniques for RC and analyses the current landscape of complications after cystectomy. There is significant room for improvement with respect to both oncologic and functional outcomes after RC. Future efforts will need to focus on unifying reporting methodology, optimal patient selection criteria, enhanced surgical techniques and peri-operative care pathways, and technological advances to improve patient outcomes.
根治性膀胱切除术(RC)联合尿流改道术被认为是肌层浸润性膀胱癌(MIBC)的标准治疗方法。作为泌尿外科医生实施的最具挑战性的外科技术之一,RC在几十年前就已被描述,但多年来患者的发病率一直停滞不前。本综述概述了RC的最新适应症和技术,并分析了膀胱切除术后并发症的现状。RC术后在肿瘤学和功能结局方面仍有很大的改进空间。未来的努力需要集中在统一报告方法、优化患者选择标准、改进手术技术和围手术期护理路径以及技术进步以改善患者结局。