当院8年間の膀胱全摘除術施行症例の臨床統計

Abstract

患者39例につき, 1)男女比は31:8で平均年齢は64.9歳であった.2)腫瘍組織像は, 移行上皮癌36例, 扁平上皮癌2例, 平滑筋肉腫1例であった.3)尿路変更術は, 回腸導管造設術32例, 尿管皮膚瘻術7例であった.4)術後1ヵ月以内の死亡率は2.6%であった.5)術後早期合併症では, 創部感染, 腎盂腎炎, 創し開などの感染症が多かった.6)術後晩期合併症では, 腸管を用いた尿路変更術に関連するものが多かった.7)全体の実測(相対)生存率は, 1年89.5(92.4)%, 3年50.9(56.6)%, 5年34.5(41.7)%であった.8) gradeおよびstage別の予後では, high grade, high stageのものが不良であった.平均年齢を境にした年齢別の予後の比較では有意差をみとめなかった

Between 1975 and 1982, 39 patients underwent total cystectomy and urinary diversion at our hospitals. The type of urinary diversions were ileal conduit (32 cases) and ureterocutaneostomy (7 cases). Preoperative irradiation was used in 10 patients. The postoperative mortality rate was 2.6%. Early complications occurred in 38.5% and included wound infection, acute pyelonephritis, intestinal obstruction, pelvic infection, intestinal leakage and/or medical complications. Ureteroileal stricture was most frequent in late complications. Over-all relative 1-, 3-, and 5-year survival rates were 92.4, 56.6, 41.7%, respectively. Survival was dependent on the stage and the grade of the tumor. No significant difference was found between the older (greater than or equal to 65 years old) and the younger (less than 65 years old) groups.