一次性膀胱全切除术在膀胱肿瘤治疗中的意义

１９６６年～１９９３年共收治膀胱肿瘤３５２例，其中７３例（２０．１％）施行了膀胱全切除术、随访了手术时机与术后存活时间的关系。４０例第一次确诊即行全切除者，２０例（５０％）存活５年以上，１４例（３５％）存活１０年以上；３３例在１～４次膀胱部分切除术后复发，再行全膀胱切除者，１８例（５４．５％）在术后２年死亡，仅５例（１５．１％）存活５年以上。作者认为第一次确诊即行膀胱全切除可以提高长期存活率。对代膀胱的选择及尿道癌的处理进行了讨论．

Significance of Immediate Total Cystectomy in the Treatment of Bladder Carcinoma

From 1966 to March 1993,352 cases of blfldder carcinoma were treated in our de partment.73(20.1%)were operated on for total cystectomy.The relationship of operative opper tunity and postoperative survival rate was followed-up.Among 73 cases,40 recepted total cystec tomy immediately when patients were firstly and definitely diagnosed as bladder carcinoma.20 of the 40(50%)were alive more than 5 years postoperatively and 14(35%)more than 10 years.Oth er 33 cases underwent total cystectomy after recurrence of partial cystectomy for 1～4 time.18 of the 33(54.5%)survived less than 2 years,only 5 lived more than 5 years.Authors hold that long-term survival rate may be raised by immediate total cystectomy when patients are firstly and definitely diagnosed as bladder carcinoma.In this paper,choise of bladder substitution and treat ment of urethral cancer were also discussed.