The Value Of Bladder Resection Combined Regional Lymph Node Cleaning In The Treatment Of Muscular Layer Value Of Invasive Bladder Cancer

Objective: With the bladder cancer incidence increasing for recent years and the requiments for higher level of life quality after operation, people pay more attention to partial cystectomy.The objective is to evaluate the value of partial cystectomy with regional lymph node cleaning in the treatment of muscle invasive bladder cancer.Methods: Retrospective analysis 150 patients with muscle invasive bladder cancer in our hospital and Dalian Central Hospital from 1st January,2008 to 31 th December,2014.Including,24 cases received partial cystectomy with regional lymph node cleaning,50 cases just partial cystectomy,and other 76 cases underwent radicial cystectomy.Observe and review the 150 cases’ medical record,image materials,pathology and follow-up visit,then utilize Kaplan-Meier survial function and compare with the long-term survial rates of three groupsThe average follow-up was 32.65 months(1 to 70 months),The median follow-up was 30.5 months,all of the pathyology results are urothelium carcinoma,20 cases of 24 with partial cystectomy accompanied with lymphatic metastasis,2 case recurred within 3 months.there were 48 caes with lymphatic metastasis in radicial cystectomy group.9 cases of partial cystectomy group recurred with 3months.3-year-survial rate of radicial cystectomy group was 61.8%,5-year-survial rate is 49.8%,3-year-survial rate of partial cystectomy group was 66.7%,5-year-survial rate is 50%,3-year-survial rate of partial cystectomy with regional lymph node cleaning group was 52.4%,5-year-survial rate is 43.5%. There was no statistically significant difference(P=0.754) between radicial cystectomy group and MMC partial cystectomy with regional lymph node cleaning group.while survial rate of partial cystectomy group is obviously lower than other two groups.Results: 150 patients with bladder cancer are the surgical indications of a radical cystectomy, among them 74 cases due to physical or refused to wait for a reason, full bladder resection for keeping bladder. Preoperative assessment after resection of bladder, of which 24 cases with intraoperative regional lymph node cleaning, the regional lymph nodes were 50 cases of patients who did not. Three groups of patients with Kaplan Meier- survival analysis respectively, the average follow-up time of 32.65 months(1-70) month, median follow-up time was 30.5 months, radical bladder full set of postoperative patients with 3 years and 5 years survival rate was 61.8% and 49.8%. Bladder resection with regional lymph node cleaning the patients for 3 years and 5 years survival rates were 66.7% and 50% respectively. Patients with bladder resection group without lymph node cleaning for 3 years and 5 years survival rates were 52.4% and 43.5% respectively. Bladder full cut part with bladder suit the lymph node and group the results there was no significant difference after statistics analysis(P = 0.754). The lymph node and bladder resection line group compared with the survival rate was significantly lower. Three groups of patients with postoperative pathological diagnosis of urothelial carcinoma, 24 patients underwent resection of the bladder in patients, 20 postoperative with regional lymph node metastasis(83%). The postoperative bladder recurrence within 3 months; Bladder full postoperative pathological diagnosis of lymph node metastasis group 48(63.16%); Bladder resection group without lymph node cleaning the postoperative 3 months inside bladder recurrence 9 people.Conclusion :1.After preoperative MIBC of reasonable selection of patients with bladder resection with lymph node cleaning operation patients with radical cystectomy in 3 years and 5 years on the survival rate and no difference,But patients with bladder resection group without lymph node cleaning in 3 years, 5 years survival rate is lower than the other two groups.Bladder not only retained the lymph node resection combined surgery in patients with bladder, and to improve the postoperative survival rate and improve the patients quality of life, is a kind of feasible operation method. 2.Line bladder resection with lymph node cleaning the surgery patients must go through strict screening, postoperative bladder perfusion treatment in time, close follow-up. 3.In patients with bladder resection operation of regional lymph node cleaning is very necessary, can significantly improve the postoperative survival rate, reduce the recurrence.4.This study discusses the bladder resection with lymph node cleaning technique in the treatment of muscular layer feasibility of invasive bladder cancer, for some of the many medical disease- merger is unfavorable in patients undergoing radical cystectomy and retain strong appetite bladder provides the feasible treatment of patients. This data shows, in accord with bladder full cut method under the condition of surgical indications, the lymph node bladder resection combined with radical operation 3 years postoperatively in patients with bladder full cut method and the 5-year survival rate and no obvious difference, the exact conclusion large sample research is further confirmed.