The efficacy and safety of transurethral partial cystectomy combined with intravesical suturation in the treatment of bladder cancer
10.3760/cma.j.cn112330-20220126-00035
- VernacularTitle:经尿道膀胱部分切除术联合膀胱腔内缝合术治疗膀胱癌的有效性及安全性分析
- Author:
Yaohui MA
1
;
Liang GUO
;
Kun CHEN
;
Shuiliang AN
;
Lei XU
;
Zhongjie SHAN
Author Information
1. 河南中医药大学第五临床医学院 郑州人民医院泌尿外科，郑州 450000
- Keywords:
Urinary bladder neoplasms;
Intracavitary suturation;
Transurethral resection of bladder tumor;
Non-muscular infiltration;
Partial cystectomy
- From:
Chinese Journal of Urology
2023;44(1):16-20
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the efficacy and safety of transurethral partial cystectomy combined with intravesical suturation in the treatment of bladder cancer.Methods:The clinical data of 28 patients with bladder cancer who were admitted in Zhengzhou People's Hospital from July 2020 to October 2021 were analyzed retrospectively. There were 22 males and 6 females, with the average age of (68.8±8.9) years old. Twenty cases were with single bladder tumor, and 8 cases were with multiple bladder tumors. The diameter of single bladder tumor measured by CT was less than 4 cm, with a median tumor diameter of 2.3(0.9, 2.8)cm. All 28 patients underwent transurethral partial cystectomy combined with intravesical suturation for the first time. Intraoperative intravesical instillation was conducted with 1 g gemcitabine. Bladder hot reperfusion treatment was performed with gemcitabine 2 g at 45℃ immediately after operation. The patients underwent reexamination with cystoscopy every 3 months after operation.Results:All the 28 patients successfully completed the operation. The average operation time was (128.3±16.3)min. No obturator nerve reflection was induced during operation. Muscularis tissue was found in all tumor pathological specimens after operation, among which 4 cases showed muscularis infiltration. Pathology of tumor basal and peripheral tissues showed tumor cell infiltration in 3 cases (1 case full-thickness infiltration, namely the incision margin was positive). The median continuous irrigation time of bladder after operation was 24.0(20.9, 25.0)h. The median time of indwelling catheter after operation was 6.5(6.0, 7.0)days, and one case developed severe bladder spasm. All patients were followed up, with a median follow-up of 7.5(4.0, 10.8) months.Postoperative recurrence occurred in 3 cases, all of which were ectopic recurrence in bladder.The 1-year recurrence rate was 10.7% (3/28).Conclusions:In the first surgical treatment of bladder cancer, transurethral partial cystectomy combined with intravesical suturation can provide accurate pathological staging, and low positive surgical margin rate. Immediate suturation of bladder wound during operation and immediate bladder perfusion chemotherapy can provide short bladder irrigation time, with few adverse reactions and low incidence of complications.
