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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Atherosclerosis unplugged: Potential mechanisms leading to the clinical manifestation of stroke caused by cigarette smoking
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Atherosclerosis unplugged: Potential mechanisms leading to the clinical manifestation of stroke caused by cigarette smoking

机译：动脉粥样硬化被拔除：导致吸烟导致中风临床表现的潜在机制

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Objectives: To report the surgical outcomes of laparoscopic radical cystectomy (LRC) with extracorporeal orthotopic ileal neobladder (OIN) in patients with muscle-invasive urothelial carcinoma of the bladder (UCB). Materials and methods: Between October 2009 and December 2011, 37 patients with muscle-invasive UCB underwent a LRC with OIN. Indications included (a) muscle-invasive UCB T2-4a, N0-Nx, M0; (b) high-risk and recurrent non-muscle-invasive tumors; (c) T1G3 plus CIS; and (d) extensive non-muscle-invasive disease that could not be controlled by transurethral resection and intravesical therapy. Demographic data, perioperative, and postoperative variables were recorded and analyzed. Results: The median operating time was 330 min, with a median estimated blood loss of 410 ml. Median length of stay was 12 days, and the mean length of the skin incision to extract the specimen and for the configuration of the neobladder was 7 ± 1 cm. The complication rate was 21.6 % (Clavien II). No Clavien III-V complications were reported. Daytime and nocturnal continence were preserved in 95 and 78 %, respectively. No local recurrence or port site metastasis occurred. Median time to disease recurrence was 14 months (IQR 9-24), and 1-year cancer-specific survival was 91.9 %. Conclusions: Laparoscopic radical cystectomy with extracorporeal ileal neobladder is a challenging procedure but technically feasible, allowing low morbidity and oncological safety. Long-term oncological results are required to definitely recognize this procedure as a standard treatment for bladder cancer.
机译：目的：报告腹腔镜根治性膀胱切除术（LRC）与体外原位回肠新膀胱（OIN）一起治疗肌肉浸润性膀胱尿路上皮癌（UCB）的患者。材料和方法：2009年10月至2011年12月，对37例肌肉浸润性UCB患者进行了OIN LRC。适应症包括（a）肌肉浸润性UCB T2-4a，N0-Nx，M0; （b）高风险和复发性非肌肉侵袭性肿瘤; （c）T1G3加CIS; （d）经尿道切除术和膀胱内治疗无法控制的广泛的非肌肉侵入性疾病。记录并分析人口统计学数据，围手术期和术后变量。结果：中位手术时间为330分钟，估计失血量为410毫升。中位住院时间为12天，平均皮肤切口长度为7±1 cm，以提取标本和新膀胱。并发症发生率为21.6％（Clavien II）。没有报道Clavien III-V并发症。白天和夜间尿失禁分别保持在95％和78％。没有发生局部复发或港口部位转移。疾病复发的中位时间为14个月（IQR 9-24），并且1年癌症特异性生存率为91.9％。结论：腹腔镜根治性膀胱切除术结合体外回肠新膀胱术是一项具有挑战性的手术，但在技术上可行，从而具有较低的发病率和肿瘤学安全性。需要长期的肿瘤学结果才能明确地将该方法识别为膀胱癌的标准治疗方法。

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