术前风险因素对浸润性膀胱癌患者手术方式选择的评估价值被引量：2

The benefits of estimating surgical options by PRS in patients with invasive bladder cancer

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摘要目的探讨术前风险因素（PRS）对浸润性膀胱癌患者手术方式选择的评估价值。方法收集2012年1月至2014年12月该院244例浸润性膀胱癌患者的临床资料,采用生理能力与手术侵袭度评分系统（E-PASS）计算PRS,分析PRS与不同术式患者术后发生并发症风险的关系。结果膀胱全切原位膀胱术患者PRS评分为0.342±0.209,PRS≥0.23术后发生并发症的风险明显升高（P=0.002）;膀胱全切回肠输出道术患者PRS评分为0.401±0.224,PRS≥0.48术后发生并发症的风险明显升高（P=0.050）;膀胱全切输尿管皮肤造口术患者PRS评分为0.556±0.308,PRS≥0.60术后发生并发症的风险明显升高（P=0.009）。结论 PRS低于0.23分建议选择膀胱全切原位膀胱术;PRS 0.23-〈0.48建议选择膀胱全切回肠输出道术;PRS0.48-0.59分建议选择膀胱全切输尿管皮肤造口术。 Objective To evaluate the value of preoperative risk score（PRS）for predicting surgical options in invasive bladder cancer surgery.Methods We collected the clinical data of 244 cases with invasive bladder cancer from January 2012 to December 2014 in department of urinary surgery of the first affiliated hospital of Chongqing medical university,and then we calculated the PRS by estimation of physiologic ability and surgical stress（E-PASS）,and lysed the relationship between PRS and postoperative complications in different surgical methods.Results The PRS with orthotopic neobladder was 0.342±0.209,the risk of complications increased significantly in patients of PRS≥0.23（P=0.002）.The PRS with urinary diversion was 0.401±0.224,the risk of complications increased significantly in patients of PRS≥0.48（P=0.050）.The PRS with cutaneous ureterostomy was 0.556±0.308,the risk of complications increased significantly in patients of PRS≥0.60（P=0.009）.Conclusion Patients of PRS less than0.23 were advised to choose the orthotopic neobladder;patients of PRS between 0.23 and 0.47 advised to choose urinary diversion;patients of PRS between 0.48 and 0.59 were advised to choose cutaneous ureterostomy.

作者顾洪陈刚张尧何云锋吴小候

机构地区重庆医科大学附属第一医院泌尿外科

出处《重庆医学》 CAS 北大核心 2016年第14期1909-1911,1914,共4页 Chongqing medicine

基金重庆市科技计划项目(cstc2014yykfA0205)

关键词膀胱肿瘤风险调节术前风险因素术后并发症 urinary bladder neoplasms risk adjustment preoperative risk score postoperative complication

分类号 R737.14 [医药卫生—肿瘤]

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1Gakis G, Efstathiou J,Lerner SP, et al. ICUD-EAU inter- national consultation on bladder cancer 2012:radical cys- tectomy and bladder preservation for muscle-invasive urothelial carcinoma of the bladder[J]. Eur Urol, 2013,63 (1) :45-57.
2Takada N, Abe T, Shinohara N, et al. Peri-operative mor- bidity and mortality related to radical cystectomy:a multi- institutional retrospective study in Japan[J]. BJU Int, 2012,110(11 Pt B) ;E756-764.
3Ramani VA, Bromage SJ, Clarke NW. A contemporary stand- ard for morbidity and outcome after radical cystectomy[J]. BJU Int,2009,104(5) :628-632.
4May M, Fuhrer S, Braun KP, et al. Results from three munic- ipal hospitals regarding radical cystectomy on elderly patients [J]. Int Braz J Urol,2008,33(6) :764-773.
5Haga Y,Ikei S,Wada Y,et al. Evaluation of an estimation of physiologic ability and surgical stress (E-PASS) sco- ring system to predict postoperative risk: a multicenter prospective study[J]. Surg Today,2001,31(7):569-574.
6Campillo-Soto A,Flores-Pastor B,Soria-Aledo V, et al. The POSSUM scoring system: an instru- ment for measuring quality in surgical patients[J]. Cir Esp,2006,80(6) :395-399.
7Tekkis PP,Prytherch DR,Kocher HM, et al. Development of a dedicated risk-adjustment scoring system for colorectal sur- gery (colorectal POSSUM)[J]. Br J Surg,2004,91(9) :1174- 1182.
8Ariake K, Ueno T, Takahashi M, et al. E-PASS compre- hensive risk score is a good predictor of postsrgical mor- tality from comorbid disease in elderly gastric cancer pa- tients[J]. J Surg Oncol,2014,109(6) :586-592.
9Hirose J, Taniwaki T, Fujimoto T, et al. Validity of E- PASS system for postoperative morbidity of spinal sur- gery[J]. J Spinal Disord Tech,2015,28(10) :E595-600.
10Russell SD, Saval MA, Robbins JL, et al. New York heart association functional class predicts exercise parameters in the current era[J]. Am Heart J,2009,158 (4 Suppl): S24-30.