Salvage Sistektominini Erken Dönem Sonuçları

Amaç: Kurtarma sistektomisi; mesane tümörü için başarısız küratif tedavi sonrası tümörün nüks etmesi sonucunda yapılan sistektomi tipidir. Biz bu endikasyonla kliniğimizde yapmış olduğumuz kurtarma sistektomilerinin sonuçlarını literatür eşliğinde retrospektif olarak değerlendirmeyi amaçladık. Materyal ve Metod: Ağustos 2011 ile Mayıs 2013 tarihleri arasında mesane tümörü tanısı ile kurtarma sistektomisi yapılan 11 hasta demografik özellikleri, preoperatif ve postoperatif patolojileri, perioperatif ve postoperatif komplikasyonları ve üriner diversiyon yöntemleri açısından retrospektif olarak değerlendirildi. Bulgular: Operasyon sonrası hastaların ortalama takip süresi 10,3 (3-20,8) ay idi. Sistektomi öncesi Transüretral rezeksiyon (TUR) materyallerine göre yapılan patolojik evrelemede 2 hastada T1 (%18,1), 8 hastada T2 (%72,7) 1 hastada T4 (%9) iken; sistektomi sonrası patolojik incelemede bu dağılım , 4 hastada T2 (%36,3), 3 hastada T3 (%27,2) ve 4 hastada T4 (%36,3) olarak bulundu. Hastaların 1'inde skuamöz hücreli karsinom bildirilirken, 2 hastada lenf nodu tutulumu bildirildi. Postoperatif erken (

Short Term Outcomes of Salvage Cystectomy

Purpose: Salvage cystectomy is performed when recurrences or treatment failures occur or curative treatment for bladder cancer is not possible . In this article, we aimed to present our experience of salvage cystectomies in light of current literature. Material and Methods: Folders of patients underwent salvage cystectomy between August 2011 and May 2013 were compared according to demographics, pre and post operative pathology reports, complicatons and types of urinary divertion. Results: Mean follow-up was 10,3 (3-20,8) months. When pathologies were compared by peroperative transurethral resection (TUR), 2 (18.1%) patients were T1, 8 (%72.7) patients were T2, 1 (9%) patient was T4; pathology specimens following cystectomy was T2 in 4 (36.3%), T3 in 3 (27.2%) and T4 in 4 (36.3%) patients. 1 patient had squamous cell carcinoma, 2 patients had lymph node metastasis. 1 patient suffered from bleeding, one patient sufferd from ileal extravasation, 1 suffered from urine extravasation and one patient suffered from infection in early postoperative period (

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  • Zlotta AR, Schulman CC. Biological markers insuperficial bladder tumors and their prognostic significance. Urol Clin North Am. 2000;27:179-89
  • Zorlu F, E ser SY, Fidaner C. İzmir ilinde ürogenital kanserlerin insidans hızları (1995-96) Üroonkoloji Bülteni 2004; Mart, Sayı 1.
  • Gallagher DJ, Milowsky MI. Bladder cancer. Curr Treat Options Oncol. 2009;10:205-15.
  • Eswara JR, Efstathiou JA, Heney NM, Paly J, Kaufman DS, McDougal WS, et al. Complications and Long-Term Results of Salvage Cystectomy After Failed Bladder Sparing Therapy for Muscle Invasive Bladder Cancer. J Urol. 2012;187:463-8
  • Milosevic M, Gospodarowicz M, Zietman A, Abbas F, Haustermans K, Moonen L, et al. Radiotherapy for Bladder Cancer. Urology. 2007;69:80-92.
  • Zapatero A, Martin De Vidales C, Arellano R, Ibañez Y, Bocardo G, Perez M, et al. Long-term results of two prospective bladder-sparing trimodality approaches for invasive bladder cancer: Neoadjuvant chemotherapy and concurrent radio-chemotherapy. Urology. 2012;80:1056-62.
  • Swanson DA, von Eschenbach AC, Bracken RB, Johnson DE. Salvage cystectomy for bladder carcinoma. Cancer 1981;1;47:2275-9.
  • Eisenberg MS, Dorin RP, Bartsch G, Cai J, Miranda G, Skinner EC. Early Complications of Cystectomy After High Dose Pelvic Radiation. J Urol. 2010;184:2264-9.
  • Bricker EM. Bladder substitution after pelvic evisceration. Surg Clin North Am. 1950;30:1511–21.
  • Wallace DM. Ureteric diversion using a conduit: a simplified technique. Br J Urol. 1966;38:522-7
  • Feifer AH, Taylor JM, Tarin TV, Herr HW. Maximizing cure for muscle-invasive bladder cancer: integration of surgery and chemotherapy. Eur Urol. 2011;59:978-84.
  • Lapham RL, Grignon D, Ro JY. Pathologic .prognostic parameters in bladder urothelial biopsy, transurethral resection, and cystectomy specimens. Semin Diagn Pathol. 1997;14:109-22.
  • Ramani VA, Maddineni SB, Grey BR, Clarke NW. Differential complication rates following radical cystectomy in the irradiated and nonirradiated pelvis. Eur Urol. 2010;57:1058-63.
  • Heney NM, Natural history of bladder cancer. Urol Clin North Am. 1992;19:429-32
  • Nieuwenhuijzen JA, Horenblas S, Meinhardt W et al: Salvage cystectomy after failure of interstitial radiotherapy and external beam radiotherapy for bladder cancer. BJU Int. 2004;94:793.
  • Abratt RP, Wilson JA, Pontin AR, Barnes RD. Salvage cystectomy after radical irradiation for bladder cancer-prognostic factors and complications. Br J Urol. 1993;72:756-60.
  • Freiha FS, Faysal MH. Salvage cystectomy. Urology. 1983;22:496-8
  • Crawford ED, Skinner DG. Salvage cystectomy after irradiation failure. J Urol. 1980;123:32-4.
  • Johnson DE, LamyS, BrackenRB. Salvage cystectomy after radiation failure in patients with bladder carcinoma. South Med J. 1977;70:1279-81.
  • Bochner BH, Figueroa AJ, Skinner EC et al: Salvage radical cystoprostatectomy and orthotopic urinary diversion following radiation failure. J Urol. 1998;160:29.
  • Kouba E, Sands M, Lentz A, Wallen E, Pruthi RS. A comparison of the Bricker versus Wallace ureteroileal anastomosis undergoing urinary diversion for blader cancer. J Urol. 2007;178:945-8
  • Pappas P, Stravodimos KG, Kapetanakis T, Leonardou P, Koutallelis G, Adamakis I, Constantinides C. Ureterointestinal strictures following Bricker ileal conduit: management via a percutaneous approach. Int Urol Nephrol. 2008;40:621-7.
  • Dahm P PD. The role of cystectomy in the management of superficial bladder cancer. Urol Integr Invest. 2001;6:134-8.
  • Lerner SP, Skinner DG. Radical cystectomy for bladder cancer. In: Volgezang NJ, Scardino PT, Shiply WU, Coffey DS, eds. Comprehensive Textbook of Genitourinary Oncology. 2nd edition. Philadelphia: Lippincott, Williams&Wilkins. 2000;425
  • Skinner DG, Lieskovsky G. Management of invasive high-grade bladder cancer. In: Skinner DG, Lieskovsky G, eds. Diagnosis and Management of Genitourinary Cancer. Vol 1, Philadelphia: Saunders Comp. 1988:295-312.
  • Yazışma Adresi / Address for Correspondence: Dr . Nevzat Can Şener Sağlık Bakanlığı, Adana Numune EA Hastanesi, Üroloji Kliniği Yüreğir, ADANA e-mail: cansener14@gmail.com geliş tarihi/received :29.07.2013 kabul tarihi/accepted:02.09.2013
Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi