膀胱癌に対する根治的膀胱全摘除術の臨床的ならびに病理組織学的研究 : 第1報根治的膀胱全摘除術施行例の臨床像ならびに遠隔成績

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From April, 1959 to June, 1966, we have experienced 209 cases of the urinary bladder cancer. For their treatment we have mainly employed radical total cystectomy and partial cystectomy. This time, we have taken up the 61 radical total cystectomy cases with were operated on more than one year ago. We have pursued a follow-up study including various other studies relating to it. The results obtained are summarized as follows. 1) As for the survival rate, the study has showed a fairly satisfactory rate, 1-year-survival rate being 55.7% 3-year-survival rate 33.3% and 5-year-survival rate 22.2% respectively. The survival rate by the stages of tumor is as follows: In the cases with low stage tumor, 1-year-survival rate is 66.6%, 3-year-survival rate 37.5% and 5-year-survival rate 50.0% respectively, while in the cases with high stage tumor 1 -year-survival rate is 52.2%, 3-year-survival rate 32.1% and 5-year-survival tate 14.3% respectively. Prognosis in cases of high stage tumor, therefore, is worse than in those of low stage tumor. 2) We have studied the relationship between the methods of changing urinary tract and the survival rate. On the one hand, the survival rate in the cases employing ureterocutaneostomy is 62.2% for 1-year-survivals, 37.5% for 3-year-survivals and 33.3% for 5-year-survivals respectively. On the other hand, the survival rate in the cases employing ureterosigmoidostomy is 45.8% for 1-year-survivals, 30.0% for 3-year-survivals and 16.7% for 5-year-survivals respectively. Thus the study has showed clearly the fact that prognosis in the cases with ureterocutaneostomy is much better than those with ureterosigmoidostomy. 3) The death rate is the highest in the period within the first one year after operation, showing 44.3%. Among these cases, the most cases of death occurred in the period within the first two to six months after operation. Thus, we must emphasize that a very cautions care is needed during the first six months period after operation. 4) As for the causes of death, the rate of death due to the operation death is 8.2% the rate of death from tumor recurrence and metastasis 23.0% and the rate of death from other diseases including chronic renal insufficiency 11.8% respectively. The rate of death from unknown causes in 19.7%. The postoperative death occurred only in the operations which were made from April, 1959 to May, 1962, and none at all in the operations thereafter. This fact is considered to be due to improvement in this period in techniques of the operation and the methods of cares before and after the operation.
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膀胱癌に対する根治的膀胱全摘除術の臨床的ならびに病理組織学的研究 : 第1報根治的膀胱全摘除術施行例の臨床像ならびに遠隔成績

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膀胱癌に対する根治的膀胱全摘除術の臨床的ならびに病理組織学的研究 : 第1報 根治的膀胱全摘除術施行例の臨床像ならびに遠隔成績

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膀胱癌に対する根治的膀胱全摘除術の臨床的ならびに病理組織学的研究 : 第1報根治的膀胱全摘除術施行例の臨床像ならびに遠隔成績