Ömer YILMAZ, Sezgin ÖZÇELİK, Özgür KURUL, Cumhur YEŞİLDAL, Zeki AKTAŞ, Hasan SOYDAN, Ferhat ATEŞ, Temuçin ŞENKUL

Divertikül içi primer mesane tümörlü hastalarımızın klinik takip sonuçları

Giriş: Bu çalışmada kliniğimizde primer olarak divertikül içerisinde tespit edilen mesane tümörlerinin klinik seyirleri incelenmiştir. Gereç ve Yöntem: 2006-2015 yılları arasında divertikül içi mesane tümörü tespit edilen toplam 8 hastanın verileri retrospektif olarak değerlendirildi. Sistoskopi ile tanısı kesinleştirilen ve bilgisayarlı tomografi veya manyetik rezonans görüntüleme kullanılarak mesane dışına yayılım olmadığı gösterilen hastalara standart olarak TUR-mesane ameliyatı ve postoperatif 6 saat içerisinde intravezikal mitomisin/epirubisin kemoterapisi uygulandı. Patoloji sonuçlarına göre takip programına alınan hastalara lüzum halinde intravezikal kemoterapi/immünoterapi tedavileri de verildi. Bulgular: En sık şikayet mesane çıkım obstrüksiyonuna bağlı işeme yakınmaları ve hematüri olarak değerlendirildi. Divertikül içerisinde tespit edilen tümörlerin büyük çoğunluğu <3cm ve yarısı tek odak halinde tespit edildi. Tüm hastalarda prostat lobları obstrüktif olarak görüldü ve takip süresi içerisinde % 40 ‘ına ilave prostat cerrahisi de uygulandı. Primer tümör patolojileri %87.5 pTa düşük grade olarak raporlandı. % 62.5 hastada aynı divertikül veya mesanenin başka yerinde nüks tespit edildi. Hastaların %37.5’ i takip süresi içerisinde intravezikal kemoterapi, %25’ i immünoterapi tedavisi aldı. %37.5 hastada ilk ameliyat sonrası hiç nüks gelişmedi. Hiçbir hastada evre ilerlemesi görülmedi. 1 hastada ise nükslerinde yüksek grade ilerleme tespit edildi. Sonuç: Elde edilen verilere göre primer divertikül içi mesane tümörleri

Anahtar Kelimeler:

divertikül, Mesane, Tümörü

Clinical results of patients with primary bladder cancer inside the diverticula

Objective: In this study, we examined the clinical courses of bladder tumors primary detected in a vesicular diverticulum. Materials and Methods: We retrospectively examined our clinical data between 2006- 2015 and 8 patients has diagnosed primary bladder cancer within a vesicular diverticulum. All diagnosis were made with cystoscopic examination. After the diagnosis CT or MRI was done for the staging. Initially transurethral resection of bladder tumour with subsequent intravesical chemoterapy mitomycin\epirubicine was applied. According to the pathological results, if needed intravesical chemoterapy / immunotherapy was given in the follow up. Results: In our study diverticular bladder cancer patients generally presented to the urology service with hematuria and they were incidentally detected with USG while they were evaluating for bladder outlet obstruction. The majority of tumors detected in diverticula were <3cm and half was fixed in one focus. Obstructive prostate lobes were seen in all patients and in the follow-up period ‘s additional prostate surgery has been applied in 40% of the patients. Primary tumor pathology was reported as pTa low garde in 87.5% of the patients. In 62.5% of patients recurrence was found in the same diverticulum or in other locations of the bladder). In follow-up period intravesical chemotherapy was applied in 37.5% of the patients, 25% received treatment with immunotherapy. After the first surgery no recurrence was seen in 37.5% of patients. None of the patients showed stage progression. In one patient grade progression was seen who had disease recurrence . Conclusion: According to our current data, bladder tumors in the diverticulum tend to be small and low grade.

Keywords:

Bladder tumor, diverticulum,

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