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GREENLIGHT©激光光凝治疗放射性出血性膀胱炎:单中心系列研究结果。

Photocoagulation with GREENLIGHT© laser in radiation-induced haemorrhagic cystitis: Results of a single-center series.

机构信息

Urology & Transplantation Unit, CHU de Caen, avenue de la Côte de Nacre, 14033 Caen, France.

Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France.

出版信息

Prog Urol. 2023 Sep;33(10):488-491. doi: 10.1016/j.purol.2023.07.009. Epub 2023 Aug 6.

Abstract

INTRODUCTION

Radiation-induced haemorrhagic cystitis (RIHC) is one complication of the pelvic radiotherapy. The GREENLIGHT© laser (GL) has been barely studied in the treatment of radiation cystitis. The primary objective was to evaluate the efficacy of GL in refractory RIHC patients (RRC) in a single-centre series.

MATERIALS AND METHODS

Twenty-nine patients were treated by GL bladder photocoagulation (GLBP). These patients showed signs of refractory haematuria in the context of RIHC. The primary endpoint was the absence of haematuria that would require a subsequent surgical intervention. Secondary endpoints were postoperative hospitalization length of stay, the occurrence of complications according to the Clavien-Dindo classification, the occurrence of functional urinary disorders and the number of cystectomies.

RESULTS

After a median follow-up of 30 months, 24 (82.7%) patients had no recurrence of haematuria. No postoperative complications were reported. A disabling overactive bladder secondary to the procedure occurred in 9 patients (31.0%). Two patients needed a cystectomy at 1 and 11 months.

CONCLUSION

GLBP may constitute an efficient line of treatment for RIHC. Despite overactive bladder it allowed to avoid or delay cystectomy.

摘要

介绍

放射性出血性膀胱炎(RIHC)是盆腔放疗的一种并发症。绿光激光(GL)在放射性膀胱炎的治疗中研究甚少。本研究的主要目的是在单中心系列研究中评估 GL 治疗难治性 RIHC 患者(RRC)的疗效。

材料和方法

29 例患者接受了 GL 膀胱光凝(GLBP)治疗。这些患者在 RIHC 背景下出现难治性血尿的迹象。主要终点是无血尿,无需后续手术干预。次要终点是术后住院时间、根据 Clavien-Dindo 分类发生的并发症、功能性尿失禁的发生和膀胱切除术的数量。

结果

中位随访 30 个月后,24 例(82.7%)患者无血尿复发。无术后并发症。9 例患者(31.0%)发生与手术相关的严重逼尿肌过度活动。2 例患者分别在 1 个月和 11 个月时需要行膀胱切除术。

结论

GLBP 可能是 RIHC 的一种有效治疗方法。尽管有逼尿肌过度活动,但它可以避免或延迟膀胱切除术。

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