Radical Cystectomy in Female Patients-Improving Outcomes

被引:6
作者
Kalampokis, Nikolaos [1 ]
Grivas, Nikolaos [1 ,2 ]
Oelschlaeger, Markus [3 ]
Hassan, Fahmy Nabil [3 ]
Gakis, Georgios [3 ]
机构
[1] G Hatzikosta Gen Hosp, Dept Urol, Ioannina, Greece
[2] Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Urol, Amsterdam, Netherlands
[3] Julius Maximillians Univ, Dept Urol & Pediat Urol, Univ Hosp Wurzburg, Oberdurrbacher Str 6, D-97080 Wurzburg, Germany
关键词
Bladder cancer; Diversion; Outcomes; Radical cystectomy; Women; QUALITY-OF-LIFE; TRANSITIONAL-CELL CARCINOMA; ORTHOTOPIC BLADDER SUBSTITUTION; EAU INTERNATIONAL CONSULTATION; FROZEN-SECTION ANALYSIS; ANTERIOR VAGINAL WALL; URINARY-DIVERSION; URETHRAL RECURRENCE; ILEAL NEOBLADDER; SEXUAL DYSFUNCTION;
D O I
10.1007/s11934-019-0951-z
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose of Review To review the methods of improving surgical, oncological, and functional outcomes in women with bladder cancer treated with radical cystectomy. Recent Findings omicron rthotopic urinary diversion (ONB) is a safe option for well-selected women as it combines high rates of daytime and nighttime continence with exceptional oncologic outcomes. It is considered safe even for patients with limited lymph node disease and trigone involvement, as long as a preoperative biopsy of the bladder neck or an intraoperative frozen section analysis of distal urethral margin rules out malignant disease. Nerve-sparing techniques have shown promising results. For well-selected patients with early invasive disease, sparing of internal genitalia has proven to be oncologically safe. Yet, generally accepted and evidence-based oncological and functional follow-up schemes for women after radical cystectomy are still lacking. Properly designed prospective studies are needed with adequate number of participants in order to safely conclude about a broader use of pelvic organ-sparing cystectomy.
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页数:10
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