文章：

盆腔根治性切除术治疗“终末期放射性膀胱”

Pelvic Extirpative Surgery for the “End-Stage Irradiated Bladder”

原文发布日期：24 August 2023

DOI: 10.3390/cancers15174238

类型: Article

开放获取: 是

英文摘要：

Men with prostate cancer have the daunting task of selecting from multiple modalities of treatment. The long-term effects of radiation therapy are only now being recognized. For both patients and surgeons, the end-stage irradiated bladder poses numerous problems and challenges. Specifically, irradiated bladders with urosymphyseal fistula, radiation cystitis, and rectourethral fistula are challenging to manage and treat. This review outlines the presentation, workup, and management including cystectomy for these three devastating late complications of radiation therapy. There are special considerations when performing benign cystectomy that are not typically considered during oncologic cystectomy. We discuss an overview of the current literature regarding the “end-stage bladder” resulting from radiation therapy and the important considerations that must be acknowledged when managing these patients. It is shown that many of the less invasive and conservative options ultimately lead to cystectomy. Indeed, our review concludes that cystectomy with urinary diversion is a safe and viable option in select irradiated patients with the goal to improve quality of life.

摘要翻译： 

前列腺癌患者面临从多种治疗方式中做出选择的艰巨任务。放疗的长期影响直到最近才逐渐被认知。对于患者和外科医生而言，终末期放射性膀胱病变带来了诸多难题与挑战。特别是伴有耻骨联合瘘、放射性膀胱炎及直肠尿道瘘的放射性膀胱病变，其临床处理与治疗尤为复杂。本综述系统阐述了这三种严重放疗晚期并发症的临床表现、检查评估及治疗方案（包括膀胱切除术）。良性病变膀胱切除术中存在肿瘤性膀胱切除术通常无需考虑的特殊注意事项。本文综合当前关于放疗所致"终末期膀胱"的文献资料，重点探讨临床处理此类患者时必须关注的关键问题。研究表明，许多微创及保守治疗方案最终仍可能导向膀胱切除术。事实上，本综述得出结论：对于特定放射性膀胱病变患者，膀胱切除联合尿流改道术是安全可行的治疗选择，其根本目标在于改善患者生活质量。

原文链接：

Pelvic Extirpative Surgery for the “End-Stage Irradiated Bladder”