根治性膀胱切除术中扩大淋巴结清扫术不可滥用

No abuse of extended pelvic lymph node dissection in radical cystectomy

根治性膀胱全切+尿流改道术是目前肌层浸润性膀胱肿瘤的首选治疗,盆腔淋巴结清扫术是其中的必要步骤,其对进行肿瘤准确分期、判断患者预后、提高患者的生存率至关重要,而是否所有膀胱癌患者都应该行扩大淋巴结清扫术学界尚无定论。在此,作者结合文献报道和临床诊治体会,就根治性膀胱切除术中扩大淋巴结清扫术的意义与适应征作一简要探讨。

Radical cystectomy （RC） with urinary diversion is the first‐choice of muscle invasive bladder cancer （MIBC） , in which pelvic lymph node dissection （PLND） is one of the essential procedures .It not only provides the most accurate disease staging and prognostic information ,but also results in a better disease‐free survival rate .However ,the application of PLND in the management of MIBC patients are still controversial .Based on literature and our clinical experience ,we reviewed the sig‐nificance and indications of extended PLND in RC for MIBC ,and drew the conclusion that extended PLND should not be a‐bused .