Safety of urethral preservation using urethral frozen section analysis in radical cystectomy

IF 1.6 Q3 UROLOGY & NEPHROLOGY BJUI compass Pub Date : 2024-05-30 DOI:10.1002/bco2.377

Yuto Hattori, Akihiko Nagoshi, Tasuku Fujiwara, Takanari Kambe, Yuta Mine, Hiroki Hagimoto, Yohei Abe, Daisuke Yamashita, Naofumi Tsutsumi, Noboru Shibasaki, Toshinari Yamasaki, Mutsushi Kawakita

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Abstract

Background

The objective of this study is to assess whether urethral preservation can be performed safely using frozen section analysis (FSA) of the urethral stump on urethral recurrence after radical cystectomy.

Methods

Between June 2012 and July 2022, we investigated consecutive male patients who underwent urethral FSA during radical cystectomy for urothelial carcinoma. For FSA-abnormal cases, urethrectomy was performed, and for FSA-normal cases, the urethra was preserved. The diagnostic accuracy of FSA was assessed in comparison with the pathological findings of the permanent sections of the same tissue. Postoperatively, computed tomography and urinary cytology were performed as routine surveillance of recurrence.

Results

Of the 77 patients included in this study, three patients with abnormal FSA underwent concurrent urethrectomy. The negative predictive value of urethral FSA was 100%. With a median postoperative follow-up of 38 months (interquartile ranges 21–71), no urethral recurrence was observed.

Conclusions

FSA may be useful in determining the indication for urethrectomy.

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在根治性膀胱切除术中利用尿道冰冻切片分析保留尿道的安全性

背景本研究的目的是评估在根治性膀胱切除术后尿道复发时，使用尿道残端冰冻切片分析（FSA）能否安全地保留尿道。方法在 2012 年 6 月至 2022 年 7 月期间，我们调查了在尿道上皮癌根治性膀胱切除术中接受尿道 FSA 的连续男性患者。对于 FSA 异常病例，进行了尿道切除术；对于 FSA 正常病例，保留了尿道。通过与同一组织永久切片的病理结果进行比较，评估 FSA 诊断的准确性。术后进行计算机断层扫描和尿液细胞学检查，作为复发的常规监测。结果在本研究的 77 例患者中，有 3 例 FSA 异常的患者同时接受了尿道切除术。尿道 FSA 的阴性预测值为 100%。术后随访中位数为 38 个月（四分位间范围为 21-71），未观察到尿道复发。结论 FSA 可能有助于确定尿道切除术的适应症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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