未经授权:膀胱肿瘤的治疗基于两种主要干预措施,并发症的风险可能很大。这项工作的目的是提供有关膀胱手术并发症的最新信息,详细介绍了实践中的预防措施和管理策略。
方法:使用以下关键字使用Medline书目数据库(Pubmed)进行书目搜索:经尿道膀胱电切术,膀胱切除术,新膀胱,Bricker,并发症,吻合口狭窄。
结果:经尿道膀胱切除术(TURB)基本上存在出血(2%至4%)和膀胱穿孔(1%至3%)的风险。全膀胱切除术与显著的发病率和死亡率相关,尽管最近的技术进步。最常见的早期并发症是肠梗阻(23%至30%)和感染性并发症(29%至38%)。晚期并发症包括功能性并发症(泌尿和性),吻合口狭窄(7%至12%),大陆衍生的代谢并发症(25%至46%)和非大陆衍生的口腔并发症。并发症的管理已很好地编纂。然而,必须预测并采取预防措施,尤其是感染和血栓栓塞并发症,包括详尽的术前评估,患者的康复和增强手术后的恢复。
结论:预防,分析和了解膀胱手术并发症对降低死亡率和发病率至关重要。
UNASSIGNED: The management of bladder tumors is based on two major interventions, the risks of complications of which can be significant. The objective of this work is to provide an update on the complications related to bladder surgery, to detail the preventive measures and management strategies in practice.
METHODS: Bibliographic search using Medline bibliographic database (Pubmed) using the following keywords: transurethral resection of the bladder, cystectomy, neobladder, Bricker, complications, anastomotic strictures.
RESULTS: Trans-urethral resection of the bladder (TURB) essentially exposes to the risk of hemorrhage (2 to 4%) and bladder perforation (1 to 3%). Total cystectomy is associated with significant morbidity and mortality, despite recent technical advances. The most frequent early complications are ileus (23 to 30%) and infectious complications (29 to 38%). Late complications included by functional complications (urinary and sexual), anastomotic strictures (7 to 12%), metabolic complications of continent derivation (25 to 46%) and stomial complications in case of non-continent derivation. The management of complications is well codified. It is however essential to anticipate and put in place preventive measures, especially for infectious and thromboembolic complications, including an exhaustive pre-operative assessment, prehabilitation of the patient and enhanced recovery after surgery.
CONCLUSIONS: Preventing, analyzing and understanding complications in bladder surgery is essential to reduce mortality and morbidity.