膀胱腫瘍の手術成績

Abstract

Statistical analysis was made on tumors of the urinary bladder seen in our department during the period of 10 years from 1955 to 1964. Results of prolonged observation's on cases who lived more than 5 years after operation's were also analysed. 1) Number of patients with primary bladder tumor w as 281 during the 10 year observation period, which was caliculated as 3.01% of all out-patients. Male cases exceeded female cases and the peak was seen in the 7th decade of age. 2) As clinical pictures, hematuria, pain on miction, pollakisuria and miction disturbance were frequently observed. In particularly, two third of cases with hematuria had complication of secondary bladder symptoms. Duration between the onset of symptoms and hospital consultation was less than 1 year in 70% of all cases, but there were many cases in which more than 2 years had past until the first consultation. 3) Cystoscopical examination confirmed that the basis of the bladder was the most frequent site of the tumor developed. The 60% of all cases were single and pedunculated form. 4) Surgical procedures were performed in most of cases ; transurethral resection, partial cystectomy and total cystectomy for 60% of all cases and radiation therapy and chemotherapy for 25.6%. 5) Histologically , a half of cases were found to be transitional cell carcinoma, followed by so called papilloma, squamous cell carcinoma and sarcoma as the order of frequency. 6) Results of prolonged observation. Postoperative results wit h prolonged observation were best in the group treated with transurethral resection which was 55%, followed by partial cystectomized group 25% and then total cystectomized and other non-surgically treated groups which recorded as below 10%. By histological pictures, the survival rate was 50% in cases showed A-131 types of Jewett, while it was below 10% in B2—D types. No significant difference was observed, however, between the survival rate and site of tumor developed. Among renal function tests, the results of pigment s ecretion test and the survival rate showed a relatively good correlations. The worst prognosis was demonstrated in the cases who showed results of over 10 minutes on indigocarmin excretion and below 60% on 2 hours value of PSP test. The cases who had over 40 mg/dl of NPN showed marked lowering of survival rate to below 20%. No definite correlation could be found between BUN level and survival rate.