开腹根治性膀胱切除术:过去五年的单中心结果和疗效。

IF 0.7 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Bojan Čikić, Toni Zekulić, Luka Penezić, Jerko Anđelić, Tomislav Kuliš, Hrvoje Saić, Ahmad El-Saleh, Vedran Andrijašević, Tvrtko Hudolin, Eleonora Goluža, Željko Kaštelan
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引用次数: 0

摘要

根治性膀胱切除术是许多肌层浸润性膀胱癌患者的首选治疗方式。我们对 2017 年 1 月至 2022 年 1 月在一家中心进行的开放性根治性膀胱切除术进行了回顾性研究。根据肿瘤分期、合并症、患者年龄、一般情况和偏好决定尿流改道类型。女性患者占19.5%,男性患者占80.5%,中位年龄为67岁(38-90岁)。我们进行了 96 例(44.7%)输尿管吻合术(UCS)、67 例(31.2%)回肠导管移植术和 52 例(24.2%)正位新膀胱移植术(OND)。UCS术后出现17例(7.9%)并发症,尿失禁尿路转流术后出现7例(3.2%)并发症,OND术后出现7例(3.2%)并发症。55例(25.6%)患者出现了早期并发症,其中31例(14.4%)在最初住院期间出现,24例(11.2%)在术后30天内需要再次住院。最常见的伤口相关并发症是伤口开裂,最典型的原因是感染。再次入院的主要原因是尿毒症。术后 30 天的死亡率为 0.9%。手术后 30 天出现晚期并发症的病例有 39 例(18.1%)。膀胱癌是一种死亡率很高的疾病,需要多学科和个性化的治疗方法。需要进一步发展多学科团队、围术期和术后护理以及随访策略,以改善该手术的肿瘤学和功能性结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
OPEN RADICAL CYSTECTOMY: SINGLE CENTER RESULTS AND OUTCOMES IN THE LAST FIVE YEARS.

Radical cystectomy is a therapeutic modality of choice for many patients with muscle-invasive bladder cancer. We conducted a retrospective study of open radical cystectomies performed at a single Center from January 2017 to January 2022. Decision on the urinary diversion type was based on tumor stage, comorbidities, patient age, general condition and preferences. There were 19.5% of female and 80.5% of male patients, median age 67 (range 38-90) years. We performed 96 (44.7%) ureterocutaneostomies (UCS), 67 (31.2%) ileal conduit derivations, and 52 (24.2%) orthotopic neobladder derivations (OND). There were 17 (7.9%) complications after UCS, 7 (3.2%) after incontinent urinary diversion, and 7 (3.2%) after OND. Fifty-five (25.6%) patients developed early complications, of which 31 (14.4%) during the initial hospitalization period, and 24 (11.2%) required re-hospitalization in the 30-day postoperative period. The most common wound-related complication was wound dehiscence, most typically caused by infection. The main reason for readmission was urosepsis. The 30-day mortality rate was 0.9%. Late complications that occurred 30 days after the operation were found in 39 (18.1%) cases. Bladder cancer is a high-mortality disease that requires a multidisciplinary and personalized approach. Further development of multidisciplinary teams, perioperative and postoperative care, and follow-up strategy is needed to improve the oncologic and functional outcomes of this procedure.

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来源期刊
Acta clinica Croatica
Acta clinica Croatica 医学-医学:内科
CiteScore
1.10
自引率
16.70%
发文量
38
审稿时长
6-12 weeks
期刊介绍: Acta Clinica Croatica is a peer reviewed general medical journal that publishes original articles that advance and improve medical science and practice and that serve the purpose of transfer of original and valuable information to journal readers. Acta Clinica Croatica is published in English four times a year.
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