İnvazif mesane tümörü nedeni ile radikal sistoprostatektomi sonrası üriner diversiyon uygulanan hastalarda postoperatif dönemde meydana gelen metabolik, fizyolojik ve histopatolojik değişiklikler
Postoperative metabolic, physiologic and histopathologic changes in the patients which undergone urinary diversion following radical cystoprostatectomy
- Tez No: 33082
- Danışmanlar: PROF. DR. YAVUZ ÖNOL
- Tez Türü: Tıpta Uzmanlık
- Konular: Üroloji, Urology
- Anahtar Kelimeler: Hidrolik yapılar, Mesane neoplazmları, Neoplazmlar, Postoperatif dönem, Prostatektomi, Üreterostomi, Üriner diversiyon, Hydraulic structures, Urinary bladder neoplasms, Neoplasms, Postoperative period, Prostatectomy, Ureterostomy, Urinary diversion
- Yıl: 1995
- Dil: Türkçe
- Üniversite: Gata
- Enstitü: İstanbul Haydarpaşa Numune Eğitim ve Araştırma Hastanesi
- Ana Bilim Dalı: Üroloji Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
SUMMARY Postoperative metabolic, physiologic and histopathologic changes in the patients which undergone urinary diversion following radical cystoprostatectomy due to invasive bladder cancer. Between 1986 to 1995, 49 male patients with invasive bladder tumor were treated by urinary diversions following radical pelvic surgery. Of the 49 urinary diversions, 29 were ileal conduit, 16 were orthotopic neobladder and 4 were ureterosigmoidostomy. The patients with ureterosigmoidostomy were excluded because 3 patients did not come to routine follow-ups and 1 patient was undiverted to orthotopic neobladder. Technical properties of the operations, peroperative and early postoperative complications were recorded. The postoperative evaluations included serum electrolytes and blood gas analyzes, histopathologic changes in the mucosa of ileal conduit and neobladder, potency and continence status, urodynamic studies, function of upper urinary tract and tumor progression. Early complication rates were 12,4% and 13,8% in the patients with orthotopic neobladder and ileal conduit, respectively. Late complication rates were 6,2% and 6,8% in the patients with orthotopic neobladder and ileal conduit, respectively. Although, serum chloride levels increased in 13 patients (86%) with orthotopic neobladder, their blood gas analyzes were normal. All patients with ileal conduit had increased serum chloride levels but hyperchloremic metabolic acidosis developed in only 1 patient. The increase of the serum chloride levels was statistically significant in both groups (p<0,05). Daytime continence rate was 93,3% but nighttime continence rate was 46,6% in patients with orthotopic neobladder. Intermittent catheterization was necessary in 2 patients 74programına alındılar. Yine bu gurupta, ortalama sistometrik kapasite 591,8 mi (290-1148 mi) olarak bulundu. Poş yada konduit mukozalarından postoperatif dönemde alman mukoza biyopsilerindeki en önemli histopatolojik değişiklik mukoza kalınlığnda azalma ile eşlik eden atrofı olarak saptandı. Ortotopik mesane uygulanan hastalarda genel sağ kalım oranı %93,75 iken, ileal konduit uygulanan hastalarda %58,6 olarak bulundu. İn vazif mesane kanserinde en etkin tedavinin radikal sistektomi olduğu; hastanın tümör açısından durumu, yaşı ve entellektüalitesi göz önünde bulundurularak uygun diversiyon yönteminin tercih edilmesi gerektiği sonucuna vardık. 73
Özet (Çeviri)
SUMMARY Postoperative metabolic, physiologic and histopathologic changes in the patients which undergone urinary diversion following radical cystoprostatectomy due to invasive bladder cancer. Between 1986 to 1995, 49 male patients with invasive bladder tumor were treated by urinary diversions following radical pelvic surgery. Of the 49 urinary diversions, 29 were ileal conduit, 16 were orthotopic neobladder and 4 were ureterosigmoidostomy. The patients with ureterosigmoidostomy were excluded because 3 patients did not come to routine follow-ups and 1 patient was undiverted to orthotopic neobladder. Technical properties of the operations, peroperative and early postoperative complications were recorded. The postoperative evaluations included serum electrolytes and blood gas analyzes, histopathologic changes in the mucosa of ileal conduit and neobladder, potency and continence status, urodynamic studies, function of upper urinary tract and tumor progression. Early complication rates were 12,4% and 13,8% in the patients with orthotopic neobladder and ileal conduit, respectively. Late complication rates were 6,2% and 6,8% in the patients with orthotopic neobladder and ileal conduit, respectively. Although, serum chloride levels increased in 13 patients (86%) with orthotopic neobladder, their blood gas analyzes were normal. All patients with ileal conduit had increased serum chloride levels but hyperchloremic metabolic acidosis developed in only 1 patient. The increase of the serum chloride levels was statistically significant in both groups (p<0,05). Daytime continence rate was 93,3% but nighttime continence rate was 46,6% in patients with orthotopic neobladder. Intermittent catheterization was necessary in 2 patients 74because of inability to void or maintain a post- void residual volume of 100 ml. The mean cystometric capacity was 591,8 ml (290 to 1 148 ml). The most common histopathologic change was mucosal atrophy that associated with decrease in mucosal thickness. Overall survival rates were 93,75% and 58,6% in patients with orthotopic neobladder and ileal conduit, respectively. In conclusion, we established that radical cystoprostatectomy is the most effective therapy in invasive bladder cancer and the adequate urinary diversion technique should be preferred in accordance with tumor status, patient's age and intelligence. 75
Benzer Tezler
- Ürotelyal karsinom varyantlarında msı durumu ve Her2/neu/CerbB2 amplifikasyonunun klinikopatolojik parametrelerle ilişkisi
Msi status and the relationship of Her2/neu/CerbB2 amplification with clinicopathological parameters in variants of urothelial carcinoma
CEREN SARIGÖL
- Mesane kanserli hastalarda myc ve MYCT1 genlerinin araştırılması
Investigation of MYC and MCCT1 genes in the patients with bladder cancer
SOYDAN DOĞAN
- İnvaziv mesane tümörlerinin evrelendirilmesinde, tedavinin etkinliğini ve süresini belirlemede pelvik manyetik rezonans görüntülemenin değeri
The Value of magnetic resonance imaging in the staging of invasive bladder tumors and in the evaluation of the efficacy and duration of treatment
ALİ ÜNSAL
- İnvaziv mesane tümörü nedeniyle radikal sistektomi ve üriner diversiyon ameliyatı geçiren hastaların beden imajı ve benlik saygısının değerlendirilmesi
Evaluation of body image and self-esteem of patients who underwent radical cystectomy and urinary diversion surgery due to invasive bladder tumor
HANDE ZÜMRELER
Yüksek Lisans
Türkçe
2020
Hemşirelikİstanbul Okan ÜniversitesiHemşirelik Ana Bilim Dalı
DR. ÖĞR. ÜYESİ İLKNUR ÇALIŞKAN
- İnvaziv mesane tümörü nedeniyle radikal sistektomi yapılan hastalarda prognoza etkili faktörlerin belirlenmesi
Başlık çevirisi yok
NURULLAH KARAPAZAR
Tıpta Uzmanlık
Türkçe
2023
ÜrolojiEskişehir Osmangazi ÜniversitesiÜroloji Ana Bilim Dalı
DR. ÖĞR. ÜYESİ ATA ÖZEN