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目的分析膀胱癌根治性全膀胱术后尿道复发的危险因素。方法回顾性分析膀胱癌行根治性全膀胱切除术后尿道复发34例患者的临床资料,采用Logistic检验及建立Cox风险比例模型分析术后出现尿道复发的相关因素。结果膀胱癌根治性全膀胱切除术后尿道复发率为10.9%。肿瘤大小、位置及侵犯情况、临床分期、病理分级及肿瘤状态是导致尿道复发的危险因素,其中膀胱肿瘤侵及前列腺是主要原因。结论膀胱癌根治性全膀胱切除术后尿道复发率相对较低,但预后多不佳。对于肌层浸润性膀胱癌、前列腺部受累或手术尿道切缘阳性的患者,建议行全尿道切除,并加强术后随访。
Objective To analyze the risk factors of urinary tract recurrence after radical total bladder surgery of bladder cancer. Methods The clinical data of 34 patients with urinary tract recurrence after radical cystectomy of bladder cancer were retrospectively analyzed. Logistic regression analysis and Cox risk proportion model were established to analyze the related factors of urethral recurrence. Results The recurrence rate of urethra after radical cystectomy of bladder cancer was 10.9%. Tumor size, location and invasion, clinical stage, pathological grade and tumor status are the risk factors of urethral recurrence. Bladder tumor invading the prostate is the main reason. Conclusions The urinary tract recurrence rate after radical cystectomy of bladder cancer is relatively low, but the prognosis is poor. For myometrial invasive bladder cancer, prostatic involvement or surgical urethral positive margins, the proposed total urethral resection, and to enhance postoperative follow-up.