老年膀胱癌患者围手术期处理方法分析

目的探讨老年膀胱癌患者围手术期处理方法。方法回顾分析我院1986～2004年472例60岁以上膀胱癌患者外科处理的临床资料。结果术前有并存病者152例,行膀胱全切根治术139例、膀胱部分切除术182例、经尿道膀胱电切术151例;术后出现并发症32例,围手术期死亡3例,术后第1、3、5年的生存率分别为89.0%、77.5%、70.2%。结论老年膀胱癌患者最好的方法是手术切除,但早期确诊、合理的手术时机与手术方式、合理处理并发症、充分的术前准备和完善的麻醉效果是减少并发症、提高疗效的关键。

Perioperative treatment of the elderly patients with Bladder carcinoma

Objective To explore the perioperative management of the elderl y patients with Bladder carcinoma. Methods The clinical data of surgical treat ment for Bladder carcinoma in 472 cases of over 60 years old from 1986 to 2004 w ere analyzed retrospectively. Results Preoperative 152 cases had accompanied d isease, 139 cases were subjected to radical surgery, 182 to palliative resection , 151 to TUR-bt; Postoperative complications occurred in 32 cases. Three cases w ere perioperative dead; 1?3?5-year survival rate was 89.0%, 67.5%, 51.2% respect ively. Conclusion Operative resection is an ideal way to treat the elderly pa tients with Bladder carcinoma.But early diagnosis, proper management of accompan ied diseases, full bowel preoperation, appropriate choice of anesthesia and oper ation time and surgical procedures are critical to reduce complications and enha nce the curative effect.