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盆腔排气和尿路重建:手术和瘤结局的比较分析
Chee Hoe Koo1, Barbara Noiret1, Vincent Assenat1
1Bordeaux Colorectal Institute, Tivoli Clinic, Bordeaux, France.
概括
阴道管是盆腔排泄 (PE) 后最常见的尿路转移. 替代性重建在并发症,生存和生活质量方面提供了类似的结果,对日常活动的影响很小.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 外科手术的结果
背景情况:
- 对于晚期的骨盆癌症,骨盆排骨 (PE) 需要尿路重建,通常具有高的术后发病率.
- 不同的尿路转移技术对PE后患者结果的影响尚未得到充分证实.
研究的目的:
- 为了比较皮质管与PE后的替代性尿路重建的结局.
- 评估尿路转移类型对术后发病率,生活质量,肠道功能和存活率的影响.
主要方法:
- 90名经过尿路重建的PE患者的回顾性队列研究 (2016-2023年).
- 分类尿路转移到阴道管和替代性重建.
- 评估术后发病率,生活质量 (EQ-5D-5L),肠道功能障碍 (LARS,Wexner),整体存活率 (OS) 和无病存活率 (DFS).
主要成果:
- 在69%的患者中使用状管道;在31%的患者中使用替代性重建.
- 整体术后发病率高 (66%),转移类型之间没有显著差异 (p=0.86).
- 替代性重建表明,肠道功能障碍恶化的趋势和对"常规活动"生活质量的适度影响 (p=0.046),但生存率 (OS,DFS) 是可比的.
结论:
- 皮质管仍然是PE后的标准尿路转移.
- 替代性尿路重建没有显著改变主要发病率,存活率或整体生活质量.
- 由于复杂的功能后续和与PE和尿路重建相关的高发病率,共享决策至关重要.
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