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放射性膀胱炎患者膀胱漏的管理

The Management of a Urinary Bladder Leak in a Patient with Radiation Cystitis.

作者信息

Rentiya Zubir S, Francis Deepa, Francis Sandra Mary, Inban Pugazhendi, Raj Rohan, Akuma Ogbonnaya, Akuma Chinaza Mercy, Montecino Ronald Mauricio Blanco, Singh Manjeet, Makheja Kainat, Parkash Om, Kottoor Santhosh J

机构信息

University of Virginia, Department of Radiation Oncology & Radiology, Charlottesville, VA, USA.

MedStar Georgetown University Hospital, Department of Surgery, Washington, DC, USA.

出版信息

Radiol Case Rep. 2024 Mar 28;19(6):2429-2433. doi: 10.1016/j.radcr.2024.02.115. eCollection 2024 Jun.

Abstract

Urinary dysfunction following treatment for rectal adenocarcinoma is a common and complex complication. We present a case of a 69-year-old male who underwent laparoscopic-assisted left hemicolectomy and loop ileostomy after receiving chemotherapy and radiation therapy for rectal adenocarcinoma. Postoperatively, it was incidentally discovered the patient had urinary frequency and urgency. Cystoscopy revealed radiation changes to the bladder walls and a bladder leak was confirmed by cystogram. The patient underwent successful repair of the urinary bladder leak, with challenges posed by prior radiation therapy. Effective prevention and management strategies for urinary dysfunction require a comprehensive preoperative risk assessment, consideration of nerve-preserving surgical techniques, and prompt identification and repair of postoperative complications.

摘要

直肠腺癌治疗后出现的排尿功能障碍是一种常见且复杂的并发症。我们报告一例69岁男性患者,该患者在接受直肠腺癌化疗和放疗后,接受了腹腔镜辅助左半结肠切除术和回肠袢造口术。术后,偶然发现患者有尿频和尿急症状。膀胱镜检查显示膀胱壁有放疗改变,膀胱造影证实存在膀胱漏。该患者成功进行了膀胱漏修补术,但术前放疗带来了挑战。有效的排尿功能障碍预防和管理策略需要全面的术前风险评估、考虑保留神经的手术技术,以及及时识别和修复术后并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e3e/10997864/4077568f967c/gr1.jpg

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