膀胱肿瘤膀胱切除术期间前列腺包膜能否保留：对膀胱切除标本中尿道及前列腺受累情况的研究
[Can the prostatic capsule be preserved during cystectomy for bladder tumors: a study of urethral and prostatic involvement in the cystectomy specimens].
作者信息
Plante P, Lesourd A, Blanchet P, Castagnola C, Coloby P, Daffer N, Davin J L, Desgrandchamps F, Irani J, Marechal J M, Mottet N, Pariente J L
机构信息
Groupe Tumeur de vessie infiltrante du CCAFU, Service d'Urologie, CHU Rangueil, Toulouse, France.
出版信息
Prog Urol. 1998 Feb;8(1):47-50.
OBJECTIVES
To evaluate the frequency of urethral and prostatic lesions on cystectomy specimens for bladder tumour.
MATERIAL AND METHODS
This retrospective histological study was based on 260 specimens: radical cystectomies performed in 7 operative sites. The prostate and urethra were analysed in 3 planes (upper, middle and lower thirds). The apex was studied separately. Urethral invasion was identified by continuity of the tumour or by the presence of vesical CIS.
RESULTS
Urethral involvement is frequent (30.6% cases) essentially due to contiguous invasion (43/80). CIS is the second pathological association (44 urethral CIS/75 bladder CIS). Prostatic adenocarcinoma was present in 17.8% of cases with a Gleason score > 6 for 30% of lesions.
CONCLUSION
The high frequency of urethral and prostatic involvement does not justify preservation of the prostate during cystectomy. A serial prospective study should define the precise criteria able to minimize the risk of conservative surgery.
目的
评估膀胱肿瘤膀胱切除标本中尿道和前列腺病变的发生率。
材料与方法
这项回顾性组织学研究基于260份标本：在7个手术部位进行的根治性膀胱切除术。在三个平面（上、中、下三分之一）分析前列腺和尿道。分别研究尿道尖部。通过肿瘤的连续性或膀胱原位癌（CIS）的存在来确定尿道侵犯。
结果
尿道受累很常见（30.6%的病例），主要是由于连续侵犯（43/80）。CIS是第二种病理关联（44例尿道CIS/75例膀胱CIS）。17.8%的病例存在前列腺腺癌，30%的病变Gleason评分>6。
结论
尿道和前列腺受累的高发生率并不能证明在膀胱切除术中保留前列腺是合理的。一项系列前瞻性研究应确定能够将保守手术风险降至最低的精确标准。
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