膀胱癌根治性膀胱切除术后复发尿道癌临床分析(附3例报道)  

Urethral Carcionoma after Radical Cystoctomy(Report of 3 Cases)

作　　者：张荣荣[1] 廖洪[1] 何小梅[2] 谭政[1] 

机构地区：[1]四川省肿瘤医院泌尿外科,四川成都610041 [2]四川省肿瘤医院急诊科,四川成都610041

出　　处：《华西医学》2008年第4期853-854,共2页West China Medical Journal

摘　　要：目的：探讨膀胱癌根治性膀胱切除尿流改道术后复发尿道癌的机理和诊治方法。方法：回顾性分析1994~2004年73例膀胱癌根治性膀胱切除尿流改道术后,3例发生尿道癌的临床资料。结果：2例行全尿道切除术,术后随访24~28个月无肿瘤转移。1例无手术指征者行放、化疗,治疗后7个月死于肿瘤并发症。结论：膀胱癌根治性膀胱切除术后尿道癌发生机理与尿路上皮源性肿瘤的多中心性和种植学说有一定关系;由于膀胱癌膀胱切除术后尿道癌发生率低,可以不同时行预防性尿道切除术,但术后需要长期随访。膀胱癌膀胱切除术后继发尿道癌的治疗以尿道切除术疗效较好,局部侵润远处转移者预后不良。Objective：To discuss the mechanism of the urethral recurrence after radical cystoctomy and to summarize the experience of therapy Methods the clinical date of 3 patients with urethral recurrence after radical cystoctomy were retrospectively analyzed.the rate of urethral recurrence was 4.1%（3/73）.2 cases of the urethral recurrence following bladder cancer.1 case following pelve caner and bladder cancer,ileal neobladder was performed in 1 case,colonic neobladder was performed in 1 case.Cecocolic continent neobladder in 1 case.the time of urethral recurrence was at 93、45、17 months after surgery.the common clinlic symptom was urethral hemosecreta.one case was the mass of urethrostoma.it of one case was the mass of pelve.Result：the follow-up was 24-28 months.2 patients survived.One patient died of the complications after radiotherapy and chemotherapy.Conclusions the mechanism of the urethral recurrence after radical cystoctomy was relative to the muticentric and seeding of urinary carcinoma.urethral resection is not at the same time of the radical cystoctomy.but It is long time of follow-up.Urethral resection is better effect surgery in urethral recurrence cases.It was bad prognosis in the advanced cases.

关 键 词：膀胱癌 膀胱切除尿流改道术 尿道癌 

分 类 号：R737.1[医药卫生—肿瘤]