根治性膀胱切除术中使用尿道冰冻切片分析保留尿道的安全性。
Safety of urethral preservation using urethral frozen section analysis in radical cystectomy.
作者信息
Hattori Yuto, Nagoshi Akihiko, Fujiwara Tasuku, Kambe Takanari, Mine Yuta, Hagimoto Hiroki, Abe Yohei, Yamashita Daisuke, Tsutsumi Naofumi, Shibasaki Noboru, Yamasaki Toshinari, Kawakita Mutsushi
机构信息
Department of Urology Kobe City Medical Centre General Hospital Kobe Japan.
Department of Pathology Kobe City Medical Centre General Hospital Kobe Japan.
出版信息
BJUI Compass. 2024 May 30;5(8):806-810. doi: 10.1002/bco2.377. eCollection 2024 Aug.
BACKGROUND
The objective of this study is to assess whether urethral preservation can be performed safely using frozen section analysis (FSA) of the urethral stump on urethral recurrence after radical cystectomy.
METHODS
Between June 2012 and July 2022, we investigated consecutive male patients who underwent urethral FSA during radical cystectomy for urothelial carcinoma. For FSA-abnormal cases, urethrectomy was performed, and for FSA-normal cases, the urethra was preserved. The diagnostic accuracy of FSA was assessed in comparison with the pathological findings of the permanent sections of the same tissue. Postoperatively, computed tomography and urinary cytology were performed as routine surveillance of recurrence.
RESULTS
Of the 77 patients included in this study, three patients with abnormal FSA underwent concurrent urethrectomy. The negative predictive value of urethral FSA was 100%. With a median postoperative follow-up of 38 months (interquartile ranges 21-71), no urethral recurrence was observed.
CONCLUSIONS
FSA may be useful in determining the indication for urethrectomy.
背景
本研究的目的是评估在根治性膀胱切除术后尿道复发时，使用尿道残端冰冻切片分析（FSA）能否安全地保留尿道。
方法
2012年6月至2022年7月期间，我们调查了在根治性膀胱切除术期间因尿路上皮癌接受尿道FSA的连续男性患者。对于FSA异常的病例，进行尿道切除术；对于FSA正常的病例，保留尿道。将FSA的诊断准确性与同一组织永久切片的病理结果进行比较评估。术后，进行计算机断层扫描和尿液细胞学检查作为复发的常规监测。
结果
本研究纳入的77例患者中，3例FSA异常的患者同时接受了尿道切除术。尿道FSA的阴性预测值为100%。术后中位随访38个月（四分位间距21 - 71），未观察到尿道复发。
结论
FSA可能有助于确定尿道切除术的指征。
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