Comparative Evaluation of the Results of Radical Surgical Treatment of Patients with Muscle-Invasive Bladder Cancer

Vladimir Iurevich Startsev, Sergey V. Sarychev, N. I. Tyapkin, G. V. Kondratiev
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Abstract

Malignant neoplasms of the bladder with invasion into the muscle layer of the organ wall (MIBC) are recognized as a highly aggressive pathology with a poorly predicted outcome, a high mortality rate, involving patients of any age without gender differences. Radical surgery’s in patients with MIBC has long and highly established itself as one of the main methods of treatment. However, the results of open surgical interventions are still accompanied by a high level of complications. The materials of medical literature (PubMed, CrossRef) for 2000–2023 were studied, with the issues of comparative evaluation of the results of surgical treatment of patients with MIBC, complications of the postoperative period. The search was conducted on the key phrases “bladder cancer”, “open cystectomy”, “robot-assisted cystectomy”, “cancer-specific survival”. The widespread introduction of video-endoscopic methods of treating patients with this disease into clinical practice has made it possible to speak about a decrease in the volume of intraoperative blood loss, the frequency of infectious complications of the wound and inpatient stay. The development of robot-assisted bladder surgery (RARC) demonstrates a number of advantages of using the daVinci robot in terms of reducing the number of postoperative complications during the traditional to study the 30–60–90-day follow-up periods. The issues of rehabilitation of patients after various methods of urine diversion, the medical-economic aspects for RARC in expert urological centers and the feasibility of the widespread introduction of this technique in medical institutions remain unclear. The coverage of these issues in the medical scientific literature is ambiguous, and therefore requires additional analysis.
肌肉浸润性膀胱癌根治术疗效比较评估
侵犯器官壁肌肉层的膀胱恶性肿瘤(MIBC)被认为是一种侵袭性很强的病变,预后差,死亡率高,患者年龄不限,无性别差异。长期以来,MIBC 患者的根治性手术一直是治疗的主要方法之一。然而,开放性手术干预的结果仍然伴随着高并发症。我们对 2000-2023 年的医学文献资料(PubMed、CrossRef)进行了研究,研究的主题是对 MIBC 患者的手术治疗效果和术后并发症进行比较评估。搜索关键词为 "膀胱癌"、"开放式膀胱切除术"、"机器人辅助膀胱切除术"、"癌症特异性生存率"。在临床实践中广泛采用视频内窥镜方法治疗这种疾病的患者,使得术中失血量、伤口感染并发症发生率和住院时间都有可能减少。机器人辅助膀胱手术(RARC)的发展证明了使用达芬奇机器人在减少术后并发症方面的诸多优势,从传统的研究到30-60-90天的随访。各种尿液转流方法后患者的康复问题、泌尿外科专家中心的 RARC 医疗经济方面以及在医疗机构广泛采用该技术的可行性仍不明确。医学科学文献对这些问题的论述含糊不清,因此需要进一步分析。
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