Urinary bladder cancer treatment method

FIELD: oncological diseases.

SUBSTANCE: invention is designed for use in complex treatment of urinary bladder cancer in case of propagation of tumor to sub-epithelium connective tissue. Method comprises transurethral resection and introduction of immune preparations and furacillin solution. Once transurethral resection completed, three-way Foli catheter is transurethrally introduced to patient, through which mixture of standard furacillin solution with 10·106 ME interferon α-2β is injected from the first postoperative day and over following 3-5 postoperative days bringing summary dose of interferon to 50·106 ME.

EFFECT: prevented traumatism of urinary bladder due to single introduction of catheter and assured continuous action of drugs without development of immune complications.

 

The invention relates to medicine, more specifically to Oncology, and can be used in the treatment of bladder cancer when the tumor spread to the depth of the subepithelial connective tissue.

There is a method of treating bladder cancer, providing surgical removal of the tumor and postoperative immunoprophylaxis with the introduction of the BCG vaccine. Each time before entering through the urethra of BCG vaccine cavity of the bladder kateteriziruyut and catheter medicinal substance is supplied into the bladder of the patient ("bladder Cancer", Matveev BP, figurine KM" Karjakin O., Moscow, "Verdana", 2001).

However, the known method of complex treatment of superficial bladder cancer has drawbacks. These include first and foremost the need for multiple catheters that repeatedly causes injury to the patient and is a source of additional urinary tract infection. In addition, the introduction of BCG vaccine had no significant effect on tumor process and led to intense local immune response.

There is a method of treatment of bladder cancer, including surgical and conservative medicinal effects. At the same time as drug use immunomodulator interferon. Intravesical sick for 3 month is in after transuretral resection of the bladder was administered weekly for 50 million IU. ("Bladder cancer", Matveev BP, Figurine KM, Karjakin O., Moscow, "Verdana", 2001).

In addition to the duration of use of drugs causes the dissatisfaction of a large number of relapse - 24.4%of what is mentioned by the authors themselves. Cannot but cause concern and noted by the authors of the degree of effectiveness of treatment the dose of immunomodulators.

The aim of the invention is the possibility of avoiding complications associated with multiple catheterization of the urinary tract, and reduce the amount of typing medicines.

This goal is achieved by the fact that after you perform a transurethral resection of the patient through the urethra impose a three-way Foley catheter, which drip continuously, starting with the first day after surgery, administering a mixture comprising a standard solution furacin and 10 million IU of interferon α-2βthe introduction of a mixture of products is carried out in 3-5 days. The total number of interferon 50 million to ME.

Comparative analysis of the known methods of treating bladder cancer and offer allows you to ascertain the significant differences and the novelty of the latter.

The novelty of the developed method is the ability to carry out long-term continuous exposure to the mucosa of the bladder lekarstvennogo through the catheter, entered once in the postoperative period. The essential difference of this method is the ability to avoid injury of the urinary tract and infection.

In the available sources of public information of Russia, CIS and abroad indications for a similar treatment of bladder cancer could not be found.

The invention is industrially applicable, it can be reproduced and repeated many times in the institutions of urology and surgery.

The claimed method of treatment of bladder cancer at a stage of its development and clinical testing was carried out treatment of 14 patients.

The method is as follows.

After performing clinical examinations, diagnosis verification and clarification of the extent of spread of malignant process in the urinary bladder of the patient is transurethral resection of the bladder. Then through the urethra into a three-way Foley catheter, which is a drip mixture of drugs, including standard solution furacin and 10 million IU interferona α-2β. Put a mixture of products is carried out from the first day after surgery, daily for 3-5 days continuously. The total number of interferon - ME 50 million.

A specific example in the execution of the method can serve as a statement of history.

Patient L., born 1940, case history No. 3560 entered the urology Department of the Rostov research ecoinstitut 09.07.2001 years with a diagnosis of bladder cancer T 1 NX MO gr.

From the anamnesis it is known that in may 2001, there are an admixture of blood in the urine. Amid conducted conservative treatment condition improved.

02.07.2001, produced by ultrasound. The kidneys are normal in size, shape and position. Cup-pelvis system is not expanded.

The bladder volume 220 ml for longitudinal scan at the rear lazerette echopositive education 16×14 mm, with scalloped contours, non-uniform.

02.07.2001, - cystoscopy. The cystoscope freely carried out through the urethra. Residual urine 50 ml Capacity bladder 250 ml. Mucosa pale pink. The mouth of the ureter at a typical location. On the back wall of the bladder in the 2nd segment villous tumor of about 15 mm in diameter.

In General, the analysis of blood from 07.07.2001: hemoglobin 147 g/l, erythrocytes 4,5×1012/l, colour index of 0.97, leukocytes 5,5×109, leukocyte formula: stab neutrophils - 4%, segmented neutrophils - 63%, monocytes - 4%, lymphocytes - 26%, eosinophils - 3%.

18.07.2001. TOUR of the bladder.

Histological analysis: No. 4961-3 from 23.07.2001, In biopsies sprawl signedoperation the th perekhodnocletocny cancer with invasion into the submucosal layer and isolated tumor emboli in the vessels thereof.

After surgery the patient through the urethra introduced a three-way Foley catheter, which drip continuously, starting with the first day after surgery, were injected drug mixture comprising a standard solution furacin and 10 million IU of interferon α-2βthe introduction of a mixture of products was carried out within 5 days. The total number of interferon - 50 million ME. Rinsing liquid in the first day was weakly stained with blood. In later completely cleared.

23.07.2001. Irrigation of the bladder terminated. The urethral catheter is removed. Recovered self urination.

24.07.2001. General condition of the patient is satisfactory. Complaints during urination does not show. The vesicular breathing, stable hemodynamics, blood pressure 130/80 MRTT, the abdomen is soft, painless, physiological functions are normal.

25.07.2001. The patient was discharged from hospital.

Clinical supervision for 25 months in the outpatient setting.

No complaints. Active.

Ultrasound 22.05.2003. The bladder volume of 300 ml. Wall thin, smooth. Pathological formations are not revealed.

14.08.2003. - cystoscopy. The cystoscope freely carried out through the urethra. The capacity of the bladder 300 ml. of tumor Recurrence no.

Technical and economic efficiency "method of treatment of bladder cancer" is in the options:

- to relieve the patient from additional pain during repeated insertion and withdrawal of the catheter and to prevent injury and infection of the urinary tract;

- to carry out sustained, and the drugs ' effects on the mucosa of the bladder;

- to introduce into the body of the patient immune drugs without complications from the local immune system and overall immune status of the patient.

A method of treating bladder cancer, including transurethral resection and the introduction of immune drugs and solution furacin, characterized in that after performing a transurethral resection of the patient through the urethra impose a three-way Foley catheter, which is performed with the first day after surgery, the introduction of the mixture a standard solution of furacin with 10 million IU of interferon α - 2β; the introduction of a mixture of products carried out during the first 3-5 days after the operation, bringing the total dose of interferon 50 million ME.



 

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