Duel B P, Hendren W H, Bauer S B, Mandell J, Colodny A, Peters C A, Atala A, Retik A B
Department of Surgery, Children's Hospital, Boston, Massachusetts, USA.
J Urol. 1996 Nov;156(5):1798-804.
We attempted to develop a rational and consistent scheme for surgical reconstruction in patients with genitourinary rhabdomyosarcoma.
We reviewed the records of 35 patients with resectable genitourinary rhabdomyosarcoma treated from 1970 to 1993.
Primary sites included bladder in 11 cases, prostate in 13, vagina/uterus in 9 and pelvic tumors of uncertain origin in 2. A total of 33 patients underwent surgery, including partial and radical cystectomy in 17 (bowel conduit diversion in 10, continent urinary diversion in 6 and ureterosigmoidostomy in 1). Overall 30 of the 33 surgical patients are free of disease 4 months to 24 years after diagnosis.
A nonrefluxing colon conduit is appropriate at cystectomy. Continent diversion fashioned from the original conduit may be planned as the patient achieves a durable disease-free status.
我们试图为泌尿生殖系统横纹肌肉瘤患者制定一个合理且一致的手术重建方案。
我们回顾了1970年至1993年期间接受可切除性泌尿生殖系统横纹肌肉瘤治疗的35例患者的记录。
原发部位包括膀胱11例、前列腺13例、阴道/子宫9例以及起源不明的盆腔肿瘤2例。共有33例患者接受了手术,其中17例行部分或根治性膀胱切除术(10例行回肠代膀胱术、6例行可控性尿流改道术、1例行输尿管乙状结肠吻合术)。总体而言,33例接受手术的患者中有30例在诊断后4个月至24年无疾病复发。
膀胱切除术中使用无反流结肠导管是合适的。随着患者达到持久的无病状态,可计划将原导管改造成可控性尿流改道。