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定期的な年次画像検査は,RCの5年以上後の新しい機能的合併症の診断に役立ちません
Joanneke B Ringia1,2, Femke E F Scholte3, Renee A G Lijnen3
1Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands. j.ringia@nki.nl.
World journal of urology
|September 3, 2025
まとめ
イレア管による根絶手術 (RC) の後の定期的な年次画像検査では,5年以上の合併症はめったに検出されない. 臨床的に示されたイメージングは,尿路腸内構造 (UES) または尿路石腫の検出のために,通常の監視よりも推奨されます.
科学分野:
- 泌尿器科
- 腫瘍学
- 放射線科
背景:
- 膀癌の標準的な治療法は,イレアル管による根幹切除 (RC) です.
- RC後の長期監視戦略は,特に通常のイメージングの有用性に関する評価を必要とします.
- ヒドロネフロシス,尿路腸構造 (UES),尿路石腫などの合併症を特定することは,患者の管理に極めて重要です.
研究 の 目的:
- イレアル管で5年以上経った合併症に対する定期的な年次画像検査の診断効果を評価する
- この患者群の新規または進行する水解症およびUESや尿細症のような画像診断による合併症の発生率を決定する.
主な方法:
- 2011年から2018年までの間,RCを受けた82人の患者の遡及的分析.
- 参加基準は,機能的フォローアップ,腫瘍学的進行,または5年以内に診断されたUESの患者を除外した.
- 機能的フォローアップには,年間イメージング (超音波またはCT) と検査が含まれていました.
主要な成果:
- 定期的な年次画像検査では,新規または進行中の水縮症 (7. 3% の患者) が発見されました.
- 尿路腸構造 (UES) は,通常の年次画像検査で診断されませんでした.
- 一例のUESは,臨床症状がさらなる調査を促した後に診断された.
結論:
- RCの5年以上の定期的な年次画像検査は,合併症の検出に限られた価値があります.
- この研究では,通常の監視画像は,UESまたはウロリチアシスの診断に役立ちません.
- 画像検査は,通常のフォローアップではなく,臨床的徴候のある症例に限るべきです.
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