新辅助介入化疗联合微创手术治疗浸润性膀胱癌 |
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引用本文: | 徐小军,汪灶昆. 新辅助介入化疗联合微创手术治疗浸润性膀胱癌[J]. 中国微创外科杂志, 2014, 0(2): 138-139,142 |
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作者姓名: | 徐小军 汪灶昆 |
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作者单位: | 扬州大学附属泰兴市人民医院泌尿外科,泰兴225400 |
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摘 要: | 目的 探讨新辅助介入化疗联合腔内手术治疗浸润性膀胱癌的临床效果.方法 对31例确诊为肌层浸润性膀胱癌(T2~4/G1~3)的患者行新辅助性介入化疗,先经股动脉入髂内动脉,尽可能到达供应肿瘤血管,给予丝裂霉素10 mg,吉西他宾1.0/m2,顺铂90 mg,明胶海绵暂时性封堵后拔管,1周后行经尿道膀胱肿瘤汽化电切术,术后即刻用丝裂霉素200 mg或吡柔比星40 mg膀胱灌注.结果 21例治疗1次,7例治疗2次(间隔1个月),3例治疗3次(间隔1~2个月).31例随访4个月~4年,平均36个月,2例术后6、10个月复发,再次重复治疗,1例因盆腔转移治疗2次后拒绝治疗,半年后死于肺转移,其余未见肿瘤复发.结论 对于局限浸润性膀胱癌的患者,采用新辅助性经髂内动脉插管介入化疗联合腔内手术治疗疗效满意.
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关 键 词: | 膀胱肿瘤 保留膀胱 新辅助介入化疗 |
Neoadjuvant Interventional Chemotherapy Combined with Minimally Invasive Surgery for Muscle-invasive Bladder Cancer |
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Affiliation: | Xu Xiaojun, Wang Zaokan. Department of Urology, Taixing People' s Hospital Affiliated to Yangzhou University, Taixing 225400, China |
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Abstract: | Objective To explore the efficacy of neoadjuvant interventional chemotherapy combined with minimally invasive surgery for muscle-invasive bladder cancer. Methods Thirty-one cases of muscle-invasive bladder cancer (T2-4/G1-3) were treated with neoadjuvant interventional chemotherapy. After femoral artery catheterization, the catheter was inserted to the internal iliac artery with mitomycin C (MMC) 10 mg, vinorelbine 1. 0/m2, cisplatin 90 mg, and then was occluded by gelfoam before extubation. Transurethral resection of bladder tumor (TURBT) was conducted after 7 days and MMC 20 mg or pirarubicin 40 mg was irrigated into the bladder through catheter infusion immediately after operation. Results A total of 21 patients received one treatment, 7 patients two treatment (interval, 1 month) and 3 patients three treatments (interval, 1 -2 months). Thirty-one cases were followed up for 4 months to 4 years (average, 36 months) ; during the period, 2 cases underwent repeated treatments due to recurrence 6 and 8 months after operation. One patient refused treatment after two treatments due to pelvic metastasis and died of pulmonary metastasis 6 months later. No recurrence was observed in the rest cases. Conclusion Neoadjuvant interventional chemotherapy combined with minimally invasive surgery is clinically effective for patients with local muscle-invasive bladder cancer. |
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Keywords: | Bladder cancer Bladder preservation Neoadjuvant interventional chemotherapy |
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