膀胱癌与尿流改道治疗策略

Bladder Cancer and Urinary Diversion

膀胱肿瘤是我国泌尿外科最常见的肿瘤,其中尿路上皮占95%。浸润性膀胱癌生物学行为高度恶性,治疗的主要方法是根治性膀胱切除术加盆腔淋巴结清扫术加尿流改道术。其被认为是标准的治疗方法。由于全膀胱切除术及尿流改道术常给患者带来生活质量的下降及精神上的压力,使患者很难接受这种手术。本文着重分析了患者的个体化治疗,应用辩证思维方法,结合患者的认知程度,结合每一名患者的身体状况、手术耐受性、预期生存及对治疗结果期待的不同,探讨适合不同患者需要的既达到肿瘤根治又易于被患者接受的尿流改道手术方式。

Muscle invasive bladder cancer, urinary diversion Bladder cancer is a common urologic malignancy. The treatments of non--muscle--invasive and muscle--invasive bladder cancer are different. A radical cystectomy has been consid- ered to be the gold standard treatment for muscle--invasive bladder cancer. However, a radical cystectomy requires urinary diversion. The quality of life （QOL） for the patients is reduced, even with the improved surgical technique of creating a neobladder, which is always inferior to the patient＇s own bladder. Therefore, bladder preservation therapy （BPT） with the intensified chemotherapy and/or radiation therapy become an alternative for the management of muscle--invasive bladder cancer. In this study, we have an individualized program of the treatment for muscle invasive bladder cancer,either bladder preserving surgeries or urinary diversion .