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Cancer Pathogenesis and Therapy 2024年第2期2卷 74-80页

作者： Hanna Maroof Louise Paramore Ahmed Ali Department of Urology Frimley Park HospitalPortsmouth RdFrimleyCamberley GU167UJUnited Kingdom

Bladder cancer encapsulates a wide spectrum of disease severities,with non-muscle invasive bladder cancer(NMIBC)representing an entirely different entity from muscle-invasive disease.Bacillus Calmette-Guerin(BCG)is one of the most successful intravesical treatment methods for patients diagnosed.However,a considerable pro-portion of patients fail to respond to BCG treatment.Given the propensity for recurrence in patients with high-risk bladder cancer,these patients present with surgical dilemmas.There is currently no gold standard for salvage treatment post-BCG failure or unified definition as to what that means.In this review,we discuss the mechanisms of action and pathophysiology of BCG,potential theories behind BCG failure,and the scope of novel treatments forthis surgical conundrum.

关键词： cystectomy Hyperthermia Induced Immunotherapy Mycobacterium bovis Non-muscle-invasive bladder cancer

Radical cystectomy for bladder cancer: oncologic outcome in 271 Chinese patients

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Chinese Journal of Cancer 2014年第3期33卷 165-171页

作者： Zhi-Ling Zhang Pei Dong Yong-Hong Li Zhuo-Wei Liu Kai Yao Hui Han Zi-Ke Qin Fang-Jian Zhou Department of Urology Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine

Few large scale studies have reported the oncologic outcome of radical cystectomy for treating bladder cancer in China; hence, we lack long-term prognostic information. The aim of the current study was to determine the survival rate and prognostic factors of patients who underwent radical cystectomy for bladder cancer in a Chinese medical center. We retrospectively analyzed clinicopathologic data from 271 bladder cancer patients who underwent radical cystectomy between 2000 and 2011. Univariate and multivariate analyses were conducted to identify independent prognostic predictors for this cohort. Median follow-up was 31.7 months(range, 0.2–139.1 months). Thirty-day mortality was(1.4%). The 5-year recurrence-free survival, cancer-specific survival(CSS), and overall survival rates were 61.6%, 72.9%, and 68.0%, respectively. The 5-year CSS rates of patients with T1–T4 disease were 90.7%, 85.0%, 51.0%, and 18.0%, respectively. Patients with organ-confined disease had a higher 5-year CSS rate than those with extravesical disease(81.4% vs. 34.9%, P cystectomy is a safe and effective method for treating bladder cancer in Chinese patients. Old age and high T category were associated with poor prognosis in bladder cancer patients who underwent radical cystectomy.

关键词： Bladder cancer radical cystectomy prognosis

Does Postoperative Rehabilitation for Radical cystectomy Call for Enhanced Recovery after Surgery?A Systematic Review and Metaanalysis

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Current Medical Science 2019年第1期39卷 99-110页

作者： Jun XIAO Meng WANG Wei HE Jing WANG Fan YANG Xue-you MA Yu ZANG Chun-guang YANG Gan YU Zhi-hua Wang Zhang-qun YE Department of Urology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Nursing Department Huanghuai UniversityZhumadian 463000China

The aim of this review was to systematically compare the outcomes of enhanced recovery after surgery(ERAS)with standard care(SC)after radical cystectomy.We performed a systematic search of PubMed,Ovid?Web of Science,and the Cochrane Library to identify studies published until September 2017 which involved a comparison of ERAS and SC.A meta-analysis was performed to assess the outcomes of ERAS versus SC.Sixteen studies including 8 prospective and 8 retrospective trials met the eligibility criteria.A total of 2100 participants were assigned to ERAS(1258 cases)or SC(842 cases).The time to first flatus passage[WMD=-0.95 days,95%Cl(-1.50,-0.41),P=0.0006],time until return to a regular diet[WMD=-2.15 days,95%Cl(-2.86,—1.45),Pcystectomy,as well as a lower rate of postoperative complications,especially paralytic ileus and cardiovascular complications.

关键词： enhanced recovery after surgery postoperative rehabilitation bladder cancer radical cystectomy meta-analysis

Robot-assisted radical cystectomy for bladder cancer: single-center experience

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Frigid Zone Medicine 2022年第1期2卷 45-52页

作者： Valentin Pavlov Marat Urmantsev Ruslan Safiullin Anton Denejko Rita Gilmanova Ruslan Abdrakhimov Bashkir State Medical University Ufa 450074Russia

Objective:Radical cystectomy remains the most effective treatment for patients with localized,invasive bladder cancer and recurrent noninvasive disease.Recently some surgeons have begun to describe outcomes associated with less invasive surgical approaches to this disease,such as laparoscopic or robotic assisted techniques.We report our maturing experience with 100 consecutive cases of robotic assisted laparoscopic radical cystectomy regarding perioperative results,pathological outcomes,and surgical complications.Methods:A total of 100 consecutive patients(73 male and 27 female)underwent robotic radical cystectomy with intracorporeal urinary diversion at our institution from February 2018 to February 2021 for clinically localized bladder cancer.Outcome measures evaluated included operative variables,hospital recovery,pathological outcomes,and complication rate.Results:The mean age of this cohort was 60.4 years(range 38 to 82).Ninety-five patients underwent ileal conduit diversion,5 received a neobladder).The mean operating room time for all patients was 184 min(min time was 160 min)and mean surgical blood loss was 286 ml.On surgical pathology,2%of the cases were pT1,35%were pT2,51+12%were pT3/T4 disease and 17%were node positive.The mean number of lymph nodes removed was 16(range 10 to 40).In no case was there a positive surgical margin.The mean days to flatus were 2.6,bowel movement 2.8 and discharge home 8.2.There were 21 postoperative complications in 20 patients with 4%having a major complication(Clavien grade 3 or higher)and 15%being readmitted within 30 days after surgery.At a mean follow-up of 12 months 3 patients had disease recurrence and died 4 of disease.Conclusions:We report a relatively large cohort and maturing experience with robotic radical cystectomy for the treatment of bladder cancer,providing acceptable surgical and pathological outcomes.These results support continued efforts to refine the surgical management of muscle-invasive bladder cancer.

关键词： bladder cystectomy admitted

Robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion

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Asian Journal of Urology 2016年第3期3卷 156-166页

作者： Jason M.Sandberg Ashok K.Hemal Department of Urology Wake Forest University School of MedicineWinstoneSalemNCUSA

Robot-assisted radical cystectomy with intracorporeal urinary diversion(RARCICUD)has only recently been explored as a viable surgical option for patients with muscle-invasive bladder cancer seeking satisfactory oncologic control while benefiting from minimally invasive surgical techniques.Inspired by earlier open and laparoscopic work,initial descriptions of RARC-ICUD were published in 2003,and have since been followed by multiple larger case series which have suggested promising outcomes for our patients.However,the rate of adoption has remained relatively slow when compared to other robotassisted procedures such as the radical prostatectomy,likely owing to longer operative times,operative complexity,costs,and uncertainty regarding oncologic efficacy.The operative technique for RARC-ICUD has evolved over the past decade and several high-volume centers have shared tips to improve efficiency and make the operation possible for a growing number of urologists.Though there are still questions regarding economic costs,effectiveness,and generalizability of outcomes reported in published data,a growing dataset has brought us ever closer to the answers.Here,we present our current operative technique for RARC-ICUD and discuss the state of the literature so that the urologist may hold an informed discussion with his or her patients.

关键词： cystectomy Robotics Urinary bladder neoplasms Urinary diversion

Late upper urinary tract urothelial carcinoma following radical cystectomy,presenting as page kidney

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Asian Journal of Urology 2021年第4期8卷 442-443页

作者： Asmaa Ismail Hazem Elmansy Walid Shahrour Owen Prowse Ahmed Kotb Department of Urology Northern Ontario School of MedicineThunder BayOntarioCanada

Dear Editor,We are describing a rare case presenting with page phenomenon,9 years post radical cystectomy for muscle invasive bladder cancer.Page kidney was developed secondary to a late recurrent urothelial tumour in the left renal pelvis.Our case is a fifty-seven-year-old gentleman presented with poorly controlled hypertension and left dull aching loin pain.His blood pressure(BP)was 180/80 mmHg at diagnosis and was down to 150/80 mmHg using angiotensin converting enzyme(ACE)inhibitor and beta blocker medications.He underwent a radical cystectomy(RC)and ileal conduit urinary diversion 9 years ago.Pathology of his cystectomy specimen was localized urothelial carcinoma with negative resection margin and negative lymph nodes(T2N0M0).Examination showed a palpable mobile mass in the left hypochondrium.

关键词： urinary cystectomy kidney

Differential diagnosis and treatment of foot drop caused by an extraneural ganglion cyst above the knee:A case report

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World Journal of Clinical Cases 2022年第21期10卷 7539-7544页

作者： Ki Hong Won Eun Young Kang Department of Rehabilitation Medicine Kwangju Christian HospitalGwangju 61661South Korea

BACKGROUND One of the causes of foot drop is compression of the common peroneal nerve caused by space-occupying lesions such as a synovial cyst or a ganglion cyst.Most previous reports have involved compressive common peroneal neuropathy by intraneural ganglion cysts and synovial cysts.Compression of the peroneal nerve by extraneural ganglion cysts is rare.We report a rare case of compressive common peroneal neuropathy by an extraneural ganglion cyst.CASE SUMMARY A 46-year-old man was hospitalized after he reported a right foot drop for 1 mo.Manual muscle testing revealed scores of 1/5 on dorsiflexion of the right ankle.Hypoesthesia and paresthesia on the right lateral leg and foot dorsum were noted.He was diagnosed with a popliteal cyst by using electrophysiologic study and popliteal ultrasound(US).To facilitate common peroneal nerve(CPN)decompression,2 cc of sticky gelatinous material was aspirated from the cyst under US guidance.Electrical stimulation and passive and assisted active ROM exercises of the right ankle and strengthening exercises for weak muscles using elastic band were prescribed based on the change of muscle power.A posterior leaf spring ankle-foot orthosis was prescribed to assist the weak dorsiflexion of the ankle.Follow-up US revealed that the cystic lesion was growing and magnetic resonance imaging demonstrated compression of the CPN by the cystic mass.The cyst was resected to prevent impending compression of the CPN.CONCLUSION Precise diagnosis and immediate treatment are important in cases of compressive common peroneal neuropathy caused by an extraneural cyst.

关键词： Foot drop Extranueral ganglion cyst Common peroneal neuropathy Popliteal ultrasound Electrodiagnostic study cystectomy Case report

Huge Bartholin’s cyst managed by primary marsupialization:A case report

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World Journal of Clinical Cases 2023年第31期11卷 7732-7737页

作者： Hao-Yu Li Dah-Ching Ding Department of Obstetrics and Gynecology Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTzu Chi UniversityHualien 970TaiwanChina Institute of Medical Sciences Tzu Chi UniversityHualien 970TaiwanChina

BACKGROUND We report on the case of a 21-year-old female who could not walk due to a huge Bartholin's cyst occupying the right vulvar region.The patient was treated by marsupialization of the Bartholin’s cyst and postoperative antibiotic therapy.CASE SUMMARY A 21-year-old female without a medical history of sexually transmitted diseases presented to our outpatient clinic with complaints of a painful vulvar lump and a green-yellowish discharge for 4 d.A large Bartholin’s cyst,10 cm in diameter,was suspected over the right side of the vulva.She was advised to be admitted to the ward for intravenous antibiotic treatment and to perform marsupialization several days later.However,the patient requested immediate surgery because of time limitations.The patient underwent marsupialization under local anesthesia.The procedure was well-tolerated.After making the incision,a significant amount of malodorous pus(approximately 30 mL)was removed from the abscess.The patient was followed up for 1 wk postoperatively.The Bartholin’s cyst regressed,and the surgical wound healed well.CONCLUSION Our case shows that an initial marsupialization followed by oral antibiotic therapy can be an appropriate treatment option for a large Bartholin’s cyst.However,depending on the patient’s condition,a suitable treatment,either cystectomy or marsupialization,can be considered.

关键词： Bartholin’s cyst Huge Marsupialization cystectomy Antibiotics Case report

Recurrent ovarian endometrioma after conservative surgery:A retrospective study

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Asian pacific Journal of Reproduction 2022年第1期11卷 20-26页

作者： Kuntima Kantawee Woraluk Somboonporn Department of Obstetrics and Gynecology Faculty of MedicineKhon Kaen University40002Thailand

Objective:To study the prevalence and associated factors of recurrent ovarian endometrioma after ovarian cystectomy.Methods:This retrospective study analyzed 303 patients who underwent cystectomy for ovarian endometrioma and had at least a 2-year follow-up at Srinagarind Hospital from January 2013 to December 2018.The patients were divided into the recurrent and nonrecurrent groups according to the findings from postoperative transvaginal ultrasonography 6 months after undergoing surgery.Nineteen factors were collected for risk evaluation.The prevalence of recurrent ovarian endometrioma and its 95%confident interval(CI)were calculated.Univariate and multivariable logistic regression analyses were performed to determine the association between factors and recurrence.Results:Recurrent ovarian endometrioma occurred in 33%(95%CI 27.7%-38.3%)patients.The median duration of followup was 36 months.during the median follow-up period of 36 months.Preoperative history of parity,preoperative infertility history,endometriosis surgery,moderate to severe dysmenorrhea,dyspareunia,intraoperative stage 4 according to revised American Society for Reproductive Medicine classification,presence of adenomyosis,and postoperative pain relief were associated factors based on univariate analysis.In contrast,infertility[odds ratio(OR)2.22,95%CI 1.14-4.33],moderate to severe dysmenorrhea(OR 2.13,95%CI 1.09-4.15),and postoperative pelvic pain relief(OR 0.22,95%CI 0.12-0.42)were independently associated factors based on multivariable logistic regression analysis.Conclusions:In our setting,preoperative infertility history and moderate to severe dysmenorrhea were associated with a higher recurrent ovarian endometrioma risk.In contrast,postoperative pain relief was significantly associated with lower recurrence risk.

关键词： Endometriosis Recurrent ovarian endometrioma Associated factors Conservative surgery Gynecologic surgical procedures Prevalence cystectomy Prognosis Risk factors

Perioperative outcomes and survival of radical cystectomy as a function of body mass index

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World Journal of Clinical Urology 2016年第1期5卷 53-59页

作者： Bethany K Burge Robert H Blackwell Andrew Wilson Robert C Flanigan Gopal N Gupta Marcus L Quek Department of Urology Loyola University Medical Center Stritch School of Medicine Loyola University

AIM: To evaluate the perioperative and long term outcomes of cystectomy in obese patients.METHODS: This is a retrospective review of 580 patients for whom radical cystectomy(RC) was performed for primary urothelial bladder cancer between November 1996-April 2013 at a single institution. Body mass index(BMI) was available for 424 patients who were categorized as underweight(< 18.5), normal(18.5-24.9), overweight(25.0-29.9), and obese(≥ 30). Baseline demographics, perioperative outcomes, and survival were assessed. Overall survival(OS) and disease specific survival(DSS) was estimated by Kaplan-Meier method. Medians were compared using the Mann-Whitney U Test. Categorical variables were compared using the χ2 test. A P-value of < 0.05 was considered statistically significant. Statistical analyses were performed using the Software Package for the Social Sciences(SPSS), Version 20(International Business Machines SPSS, Chicago, IL, United States). RESULTS: The median age of all patients was 69 years(inter-quartile range 60-75) and median followup was 23.4 mo(8.7-55.1). Patients were characterized as underweight [9,(2.1%)], normal [113,(26.7%)],overweight [160,(37.8%)], or obese [142,(33.5%)]. Estimated blood loss during RC was higher in the obese group(800 m L) as compared to the normal weight group(500 m L). However, need for transfusion(47.7% vs 52.1%), number of lymph nodes resected(32 vs 30), length of stay(9 d vs 8 d), and 30-d readmission(29.7% vs 25.2%) between obese and normal BMI patients were similar. Obese patients underwent ileal neobladder diversion in 42% of cases, compared to 24% of normal BMI patients(0.003). Normal BMI and obese patients had comparable urinary incontinence(21.4% vs 25.6%, P = 0.343), and need for intermittent catheterization(14.3% vs 5.2%, P = 0.685) at 2 years follow-up. Overall survival was better in obese compared to normal BMI patients on univariate analysis, with median survival of 67 mo vs 37 mo, respectively(P = 0.031). Disease specific survival in these populations followed the

关键词： Urinary bladder neoplasms Body mass index Obesity cystectomy Underweight