膀胱癌に対する膀胱部分切除術の臨床的ならびに病理組織学的研究 : 第1報膀胱部分切除術施行症例の臨床像ならびに遠隔成績

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From April, 1959 to August, 1965, we have experienced 185 cases of the urinary bladder cancer. Since the surgical operation such as partial cystectomy and total cystectomy was mainly employed for their treatment, the number of cases received partial cystectomy had reached over 69. Because, the conservation of the residual vesical wall after the resection of the tumor throughout partial cystectomy was assumed physiologically to be reasonable for the patient. For this reason the operation should be proved of its surgical radicality for the caricer. Therefore, the main purpose of our clinical and pathohistological studies on the bladder cancer were subjected to clarify the limitation of surgical radicality of the operation concerning the appropriate extention of its indication. Here, the results of some clinical examinations on 55 cases of more than one-year survivals received partial cystectomy were presented with references of follow-up study. First, as for survival rate, 88.0% was obtained for 3-year-survivals, while 75.0% for 5-year-survivals. Concerning the stage of the tumor, 100% of survival rate was found in the case of 1, 2, 3, and 4-year-survivals with low stage tumor, while 87.5% for 5-year-survivals. And furthermore, 70.0% for 1-year-survivals, 75.0% for 2-year-, 57.1% for 3-year-, 42.9% for 4-year-, and 50.0% for 5-year-survivals with high stage tumor, respectively. With these results we could assume that the significant surgical radicality of partial cystectomy could be found as far as the case with low stage tumor. Next, the recurrence was observed in 15 cases (27.3%). The high recurrence rate was observed when the size of the tumor was over hen's-egg as well as when the tumor was multiple or nonpapillary growth. Furthermore, it was also observed when the tumor was located in the vaults, anterior wall, or trigone of the bladder. On the other hand, the relation between the recurrence rate and the resected size of the bladder wall around the tumor was examined. The recurrence was observed in the rate of 73.3% of the case in which below 1.5 cm of bladder wall around the tumor was resected, while it was observed in the rate of 10.0% of the case in which over 1.5 cm of that was resected. With these results obtained above, we could assume that the considerable radicality of the partial cystectomy could be obtained when it was performed with the resection of over 1.5 cm of bladder wall around the low stage tumor, and that further apropriate indication of this surgical operation could be found when it was employed on the single or papillary growth and below hen's-egg sized tumor.
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膀胱癌に対する膀胱部分切除術の臨床的ならびに病理組織学的研究 : 第1報膀胱部分切除術施行症例の臨床像ならびに遠隔成績

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膀胱癌に対する膀胱部分切除術の臨床的ならびに病理組織学的研究 : 第1報 膀胱部分切除術施行症例の臨床像ならびに遠隔成績

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膀胱癌に対する膀胱部分切除術の臨床的ならびに病理組織学的研究 : 第1報膀胱部分切除術施行症例の臨床像ならびに遠隔成績