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[膀胱癌根治性膀胱切除术中新膀胱替代的指征]

[Indication of neobladder replacement in patients undergoing radical cystectomy for bladder cancer].

作者信息

Sahashi M, Ono Y, Kato N, Kinukawa T, Ohshima S

机构信息

Department of Urology, Shizuoka Saiseikai General Hospital.

出版信息

Hinyokika Kiyo. 1995 Nov;41(11):915-9.

PMID:8533698
Abstract

Neobladder replacement has become an important procedure in the patient undergoing radical cystectomy for invasive bladder cancer. It yields postoperatively excellent quality of life in these patients. The indications of the patients selection have not been established, since long-term clinical results have not been presented and some issues such as urethral recurrence of the original disease, growth of the cancer from the neobladder made of the gastrointestinal tract and influences arising from orthotopic micturition are still unclear. We reviewed the reports describing neobladder replacement in the patients undergoing cystectomy for the bladder cancer. At present the criteria of patients selection described by most authors can be summarized as follows, (1) male patients, (2) patients having an available gastrointestinal tract for reconstructing the neobladder, (3) patients having a good renal function and liver function and could tolerate for the surgery and (4) patients with no evidence of disease in their urethra and prostate (direct invasion of the disease). As to carcinoma in situ within the bladder, some authors included their indication and the others contraindication.

摘要

对于浸润性膀胱癌患者,行根治性膀胱切除术后进行新膀胱置换已成为一项重要的手术。这能使这些患者术后的生活质量极佳。由于尚未有长期临床结果公布,且一些问题(如原发病的尿道复发、由胃肠道制成的新膀胱发生肿瘤生长以及原位排尿产生的影响)仍不明确,因此患者选择的指征尚未确立。我们回顾了描述膀胱癌患者行膀胱切除术后进行新膀胱置换的报告。目前,大多数作者描述的患者选择标准可总结如下:(1)男性患者;(2)有可用胃肠道用于重建新膀胱的患者;(3)肾功能和肝功能良好且能耐受手术的患者;(4)尿道和前列腺无疾病证据(疾病直接侵犯)的患者。至于膀胱内原位癌,一些作者将其纳入指征,而另一些作者则将其列为禁忌证。

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