[斯图特斯手术是为病人的生活质量而战]。

Q4 Medicine Urologiia Pub Date : 2024-07-01
S Los M, S Makov P, V Ukharsky A
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引用次数: 0

摘要

文章介绍了一项临床观察,展示了根治性膀胱切除术后根据Studer进行的正位膀胱整形手术的功能效果,显示了术后2.5年慢性肾病(CKD)的进展。根据文献报道,术后早期存活的肌层浸润性膀胱癌且无淋巴结受累的患者,无复发和癌症特异性预期寿命超过 15 年的概率很高,但发生严重肾功能衰竭的概率高达 20%,这降低了此类患者的生活质量和寿命。在排空期膀胱内压较高的背景下,根据 Studer 标准进行正位膀胱整形手术的患者有可能出现慢性肾功能衰竭。根据临床指南,间歇性自动导尿术适用于有神经源性膀胱功能障碍(如逼尿肌张力减低)和排空期膀胱内压较高的患者,可最大限度地降低上尿路损伤的风险。管理膀胱矫形术患者的标准并未提供此类建议。还需要进行更多研究,以确定在无残余尿但排尿时膀胱内压较高的情况下,是否应该持续使用人工膀胱导尿管。
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[Studers operation is a fight for the quality of life of the patient].

The article presents a clinical observation demonstrating the functional results of orthotopic bladder plastic surgery according to Studer after radical cystectomy, which demonstrates the progression of chronic kidney disease (CKD) 2.5 years after surgery. According to the literature, patients who survived the early postoperative period with muscle-invasive bladder cancer and no lymph node involvement have a high probability of relapse-free and cancer-specific life expectancy of more than 15 years, but the probability of developing severe renal failure reaches 20%, which reduces the quality and duration of life of such patients. Progression of CKD in patients after orthotopic bladder plastic surgery according to Studer is possible against the background of high intravesical pressure in the emptying phase. According to clinical guidelines, intermittent autocatheterization is indicated for patients with neurogenic bladder dysfunction such as detrusor hypotension and high intravesical pressure during the voiding phase, minimizing the risk of upper urinary tract damage. Standards for managing patients with an orthotopic bladder do not provide such recommendations. Additional studies are needed to determine the advisability of persistent catheterization of an artificial bladder in the absence of residual urine but high intravesical pressure during urination.

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来源期刊
Urologiia
Urologiia Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
160
期刊最新文献
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