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膀胱移行细胞癌的部分膀胱切除术

Partial cystectomy for transitional cell carcinoma of the bladder.

作者信息

Lindahl F, Jørgensen D, Egvad K

出版信息

Scand J Urol Nephrol. 1984;18(2):125-9. doi: 10.3109/00365598409182179.

Abstract

Partial cystectomy was performed for urothelium-derived bladder carcinoma in 55 patients in the period 1958-78. Ureteral re-implantation was done in 14 cases. The operative mortality was 7.3%. The five-year and ten-year survival rates were, respectively, 47.1 and 35.4%. The series was subdivided according to grade and T-stage of the tumours. The patients with a grade I or II tumour had significantly better survival rates than those with a grade III or IV tumour. T1 tumours had a more favourable outcome than T2 or T3 tumours, though the difference was not statistically significant. The ten-year prognosis was best when the tumour measured less than 1 cm, but tumour size did not otherwise influence the result. The tumour recurred in 32 (58%) of the patients, in 25 of them within 2 years of operation. The attractions of partial cystectomy include avoidance of urinary diversion and possibility of later, more radical surgery. Prophylactic antibiotic treatment is recommended in order to reduce the operative mortality and morbidity.

摘要

1958年至1978年期间,对55例尿路上皮源性膀胱癌患者实施了膀胱部分切除术。其中14例进行了输尿管再植术。手术死亡率为7.3%。五年和十年生存率分别为47.1%和35.4%。该系列病例根据肿瘤分级和T分期进行了细分。I级或II级肿瘤患者的生存率明显高于III级或IV级肿瘤患者。T1期肿瘤的预后比T2或T3期肿瘤更好,尽管差异无统计学意义。肿瘤小于1 cm时十年预后最佳,但肿瘤大小在其他方面并不影响结果。32例(58%)患者出现肿瘤复发,其中25例在术后2年内复发。膀胱部分切除术的优点包括避免尿流改道以及后期进行更根治性手术的可能性。建议进行预防性抗生素治疗以降低手术死亡率和发病率。

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