partial cystectomy

Partial cystectomy can be performed when there is a limited pedunculated or short pedicle tumor in the expanded part of the bladder (especially at the top of the bladder). For cystic malignant tumors confirmed by cystoscopy before surgery, biopsy should be performed on the bladder wall around the tumor at the same time as the microscopic examination to find out whether the cancer surrounding tissue is infiltrated. If necessary, a total cystectomy should be considered, and if not, a partial cystectomy should be considered. In addition, refractory ulcers can be performed by partial treatment of the bladder, and those with bladder-related malignant tumors involving the bladder can perform partial cystectomy. Treatment of diseases: bladder tumor, bladder adenocarcinoma Indication Partial cystectomy can be performed when there is a limited pedunculated or short pedicle tumor in the expanded part of the bladder (especially at the top of the bladder). For cystic malignant tumors confirmed by cystoscopy before surgery, biopsy should be performed on the bladder wall around the tumor at the same time as the microscopic examination to find out whether the cancer surrounding tissue is infiltrated. If necessary, a total cystectomy should be considered, and if not, a partial cystectomy should be considered. In addition, refractory ulcers can be performed by partial treatment of the bladder, and those with bladder-related malignant tumors involving the bladder can perform partial cystectomy. Preoperative preparation 1. Preoperative control of urinary tract infections. Improve systemic conditions such as bleeding, shock, water and electrolyte imbalance. 2. Shave the front abdomen, groin and genital area, wash with soapy water and warm water, and disinfect with Xinjieer. 3. Put the catheter into the bladder before surgery, rinse it, fill it with flushing saline, indwell the catheter, and clamp the end. Surgical procedure 1. Position: supine position, slightly lower head. 2. Preoperative indwelling catheter, inject 200-300ml saline to fill the bladder, and clamp the catheter with forceps. If it is a bladder malignant tumor, inject 100ml of distilled water into the urine containing 60mg. 3. Incision: The median incision in the pubis. 4. Incision of the bladder: After pushing the peritoneum with gauze, the four corners of the bladder wall were clamped with four tissue clamps, and then the bladder was incised to reveal the tumor. 5. Resection of the lesion: High-frequency high-knife or surgical scissors at 2 cm from the edge of the tumor, the tumor wall with the tumor as the core was partially removed. The adherent peritoneum is removed together. If the tumor is located in the ureteral orifice, the ureteral orifice should be removed together with the lower ureter, and the ureter should be re-adjacent to the tumor-free site of the bladder wall. 6. Repair the bladder wall: After the bladder wall of the lesion is removed, the edge of the defect bladder is sutured continuously with 2-0 gut. The inner suture sutures the submucosal muscle layer and must not pass through the mucosal layer; the outer layer is line 4-0. Intermittent suture of the muscle layer. 7. Rinse the bladder: The incision can be aspirated with 300 ml of physiological saline or 6 mg of nitrogen mustard or rinsed with distilled water for 5 minutes to destroy the remaining tumor cells. 8. Bladder fistula: The steps of bladder fistula, suturing the bladder and abdominal wall are the same as those of bladder fistula. It is also possible to place a catheter through the urethra without ostomy on the pubic bone, and a cigarette is drained in the anterior bladder.

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