[经尿道膀胱肿瘤切除术(TURBT)]。

Der Urologe. Ausg. A Pub Date : 2022-01-01 Epub Date: 2022-01-04 DOI:10.1007/s00120-021-01741-z
D Oswald, M Pallauf, T R W Herrmann, C Netsch, B Becker, K Lehrich, A Miernik, D S Schöb, K D Sievert, A J Gross, J Westphal, L Lusuardi, S Deininger
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引用次数: 0

摘要

经尿道膀胱肿瘤切除术(TURBT)是诊断和初级治疗膀胱肿瘤的标准方法。经尿道膀胱肿瘤切除术(TURBT)是诊断和治疗膀胱肿瘤的标准方法。切除区域会凝固止血。重要的一点是,切除要彻底,标本中要有足够数量的逼尿肌。术后膀胱内单次灌注化疗已被证实可降低复发率。改善肿瘤可视化的方法(特别是光动力诊断)可用于提高肿瘤检出率,尤其是多灶肿瘤或原位癌(CIS)。因此,可以降低复发率和恶化率。根据 TURBT 标本的组织学检查结果,非肌层浸润性膀胱肿瘤的后续治疗方法包括化疗或卡介苗(BCG)辅助灌注治疗、二次 TURBT 和早期膀胱切除术,而对于肌层浸润性膀胱肿瘤,则应进行根治性膀胱切除术或(肿瘤学上从属的)三联疗法,即再次 TURBT、放疗和化疗。TURBT可能出现的并发症包括膀胱填塞出血、腹膜外或腹膜内膀胱穿孔以及泌尿生殖道感染。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

[Transurethral resection of bladder tumors (TURBT)].

[Transurethral resection of bladder tumors (TURBT)].

Transurethral resection of bladder tumors (TURBT) is the standard of care for the diagnostics and primary treatment of bladder tumors. These are removed by fragmentation using loop diathermy. The resection area is coagulated for hemostasis. An important aspect is always a complete resection with an adequate amount of detrusor muscle in the specimen. Postoperative intravesical instillation of single-shot chemotherapy has been proven to reduce recurrence rates. Methods for improved tumor visualization (particularly photodynamic diagnostics) are used to enhance tumor detection rates particularly in multifocal tumors or carcinoma in situ (CIS). Thus, recurrence and progression rates can be reduced. Depending on the histological examination of the TURBT specimen, follow-up treatment for non-muscle invasive bladder tumors are adjuvant instillation treatment using chemotherapy or Bacillus Calmette-Guérin (BCG), second look TURBT and early cystectomy or for muscle invasive bladder tumors, radical cystectomy or (oncologically subordinate) trimodal treatment with renewed TURBT, radiotherapy and chemotherapy are indicated. Possible complications of TURBT include bleeding with bladder tamponade, extraperitoneal or intraperitoneal bladder perforation and infections of the urogenital tract.

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