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对于低危非肌层浸润性膀胱癌经尿道切除术后无法进行膀胱内化疗单次灌注的情况，是否应推荐持续膀胱冲洗？

Should continuous bladder irrigation be recommended when single instillation of intravesical chemotherapy cannot be used after transurethral resection in low-risk non-muscle invasive bladder cancer?

作者信息

Chemi Joaquin, Villoldo Gustavo Martin

机构信息

Urology Department, Instituto Alexander Fleming, Cramer 1180, (1426) Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Bladder (San Franc). 2023 Mar 17;10:e21200002. doi: 10.14440/bladder.2023.848. eCollection 2023.

DOI:10.14440/bladder.2023.848
PMID:37006950
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10062473/
Abstract

Reducing the recurrence rate in patients with low-risk non-muscle invasive bladder cancer patients is a critical concern in the urologic community. The gold standard treatment is single instillation (SI) of intravesical chemotherapy after transurethral resection of bladder tumor (TURBT), but unfortunately, it is underused. Continuous bladder irrigation (CBI) after TURBT is an alternative strategy to SI for the prevention of bladder tumor implantation and recurrence. The aim of this review was to present the evidence that supports CBI after TURBT when SI is not possible.

摘要

降低低风险非肌层浸润性膀胱癌患者的复发率是泌尿外科领域的一个关键问题。金标准治疗方法是在经尿道膀胱肿瘤切除术（TURBT）后进行膀胱内化疗单剂量灌注（SI），但遗憾的是，这种方法未得到充分应用。TURBT术后持续膀胱冲洗（CBI）是一种替代SI的策略，用于预防膀胱肿瘤种植和复发。本综述的目的是阐述在无法进行SI时支持TURBT术后CBI的证据。

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本文引用的文献

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Eur Urol Open Sci. 2022 Jan 17;37:7-13. doi: 10.1016/j.euros.2021.12.008. eCollection 2022 Mar.
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Post-Transurethral Resection of Bladder Tumor Bladder Perforation Resulting in Mitomycin C Extravasation, Pudendal Neuralgia, and Ureterohydronephrosis.经尿道膀胱肿瘤切除术后膀胱穿孔导致丝裂霉素C外渗、阴部神经痛和输尿管肾盂积水。
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Meta-analysis of efficacy and safety of continuous saline bladder irrigation compared with intravesical chemotherapy after transurethral resection of bladder tumors.经尿道膀胱肿瘤切除术后持续生理盐水膀胱灌洗与膀胱内化疗疗效和安全性的荟萃分析。
World J Urol. 2019 Jun;37(6):1075-1084. doi: 10.1007/s00345-019-02628-7. Epub 2019 Jan 5.
4
Bladder irrigation after transurethral resection of superficial bladder cancer: a systematic review of the literature.浅表性膀胱癌经尿道切除术后的膀胱冲洗：文献系统综述
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5
Continuous saline bladder irrigation for two hours following transurethral resection of bladder tumors in patients with non-muscle invasive bladder cancer does not prevent recurrence or progression compared with intravesical Mitomycin-C.对于非肌层浸润性膀胱癌患者，经尿道膀胱肿瘤切除术后持续膀胱冲洗两小时与膀胱内灌注丝裂霉素C相比，不能预防复发或进展。
BMC Urol. 2018 Oct 24;18(1):93. doi: 10.1186/s12894-018-0408-6.
6
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EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016.EAU 指南：非肌层浸润性膀胱尿路上皮癌：2016 年更新版。
Eur Urol. 2017 Mar;71(3):447-461. doi: 10.1016/j.eururo.2016.05.041. Epub 2016 Jun 17.
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Eur Urol. 2016 Feb;69(2):231-44. doi: 10.1016/j.eururo.2015.05.050. Epub 2015 Jun 16.