经尿道膀胱肿瘤切除术联合髂内动脉栓塞化疗治疗高龄高危浸润性膀胱癌的临床效果

目的探讨经尿道膀胱肿瘤切除术(TURBt)联合髂内动脉栓塞化疗治疗因高龄高危不能耐受根治性膀胱全切的肌层浸润性膀胱癌的临床疗效。方法对2010年2月-2016年5月26例经B超、CT及膀胱镜检查确诊为肌层浸润性膀胱癌但不能耐受根治性膀胱全切的高龄高危患者采用TURBt联合髂内动脉栓塞及灌注化疗进行治疗,TURBt可于灌注化疗前或灌注化疗后进行,具体视肿瘤大小及患者病情而定。结果 26例患者手术及髂内动脉栓塞化疗均顺利完成。术前栓塞化疗16例,术后栓塞化疗1次18例,2次9例,3次5例。术后7例复发者再次行TURBt,2例2次复发,行第3次TURBt,复发者再次术前栓塞化疗1次3例。6例合并前列腺增生(BPH)致排尿困难者同时行经尿道前列腺电切术(TURP)。未发生与手术相关的严重并发症,无围手术期死亡。术后病理报告均为肌层浸润性移行细胞癌。灌注化疗期间未发生骨髓抑制、贫血和肝肾功能损害等严重毒副作用。术后随访3个月~6年,2年内死亡2例,2~5年内死亡4例,18例生存至今,2例失访。结论对于肌层浸润性膀胱癌的高龄高危患者,TURBt联合髂内动脉栓塞化疗,具有微创、痛苦小、并发症少的特点,避免了根治性膀胱全切术带来的高风险性,以及由于尿流改道而造成的生活质量下降,有效延缓了病情的进展。方法安全、疗效可靠。

TURBt combined with internal iliac artery embolization in treatment of elderly invasive bladder cancer patients with high risk

Objective?To investigate the clinical effect of transurethral resection of bladder tumor (TURBt) combined with internal iliac artery embolization in treatment of elderly invasive bladder cancer patients with high risk.?Method?From February 2010 to May 2016, 26 cases by ultrasonography, CT and cystoscopy were diagnosed with muscle invasive bladder cancer but high-risk patients cannot tolerate radical cystectomy with transurethral resection of bladder tumor (TURBt) combined with internal iliac artery infusion chemotherapy and embolization treatment, TURBt could be used in chemotherapy before or after chemotherapy, specific depending on the size of the tumor and the patient may be.?Result?The operation and internal iliac artery embolization chemotherapy in 26 patients were successfully completed. Preoperative embolization in 16 cases, 18 cases of postoperative chemoembolization 1 times, 2 times in 9 cases, 3 times in 5 cases,. Among them, 7 cases relapsed again, TURBt, 2 cases of recurrence, third cases of TURBt, 3 cases of recurrence of preoperative embolization chemotherapy 1 times. Transurethral resection of the prostate (TURP) in 6 patients with benign prostatic hyperplasia (BPH) and transurethral resection of the prostate. No serious complications associated with surgery, no perioperative death. Postoperative pathological report was a muscle invasive transitional cell carcinoma. No bone marrow suppression, anemia, liver and renal function damage and other serious side effects were not occurred during the chemotherapy. After the operation, the patients were followed up from 3 months to 6 years, 2 cases died within 2 years, 4 cases died within 2 to 5 years, 18 cases were alive, 2 cases were lost to follow-up.?Conclusion?For patients at high risk for muscle invasive bladder cancer, TURBt combined with internal iliac artery embolization chemotherapy, minimally invasive, less pain, less complications, to avoid the high risk of radical cystectomy and caused by urinary diversion due to the decline in the quality of life, can delay the disease progression. Safety and efficacy.