neoplasia vescicale
DESCRIPTION
Neoplasia Vescicale = CarcinomaTRANSCRIPT
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NEOPLASIA VESCICALE=
CARCINOMA
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PAPILLOMA VESCICALE=
TUMORE ISTOLOGICAMENTE BENIGNO
BIOLOGICAMENTE MALIGNO
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DIAGNOSI:
EMATURIA MICRO E MACROSCOPICA
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CARATTERISTICA DELL’EMATURIA MACROSCOPICAÈ CHE DEVE ESSERE:
MONOSINTOMATICA CAPRICCIOSA A CIEL SERENO
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Pz. SintomaticoValutazione fattori di rischio
Es. obiettivo
Micro-Macroematuria
ECO Apparato urinario,Es. urine, Urocoltura,Citologia? Urografia?
Rx addome, ECO Addome,Es. urine, Urocoltura,
Citologia?
SI NO
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DIAGNOSIPER IMMAGINI E STRUMENTALE
ECOGRAFIA UROGRAFIA ??? TAC (meglio se spirale multislide) [ RM ] PET-TAC (prossimo futuro) ENDOSCOPIA (diagnostico-terapeutica e stadiante)
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T. HASSAN
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Endoscopiadiagnostico-terapeutica e stadiante
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CARCINOMA VESCICALE aspetti anatomo-patologici
a) PAPILLARE a) PROLIFERANTEb) SOLIDO b) PIATTO
c) PENETRANTE
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Istologico Betta
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Istologico Betta
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Istologico Betta
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Istologico Betta
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TERAPIA
LA TERAPIA E’ GUIDATA DALLA CORRETTA STADIAZIONE SIA COME STADIO DELLA
MALATTIA ( TNM) SIA COME GRADING CELLULARE
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Istologico BettaG1 G2 G3
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Videoclip (prenderlo dal mio video endoscopia valore attuale)
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OGGI PER I PT2 VI E’ QUALCHE TRIAL IN CORSO CON LA GEMBITACINA ASSOCIATA
O MENO AD ALTRI ANTIBLASTICI.
QUESTI TRIALS SI PONGONO COME OBIETTIVOLA CONSERVAZIONE
DELLA VESCICA.
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CISTECTOMIA RADICALE
PER RADICALE SI INTENDE L’ASPORTAZIONEDELLA VESCICA, DELLA PROSTATA,
DELLE VESCICOLE SEMINALIE TALORA DELL’URETRA
CON ASSOCIATA LINFADENECTOMIAILIACO-OTTURATORIA
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Video con inizio cistectomia (RR),taglio uretra e asportazione pezzo (Alcini),Immagine pezzo anatomico senza e con uretra (RR-mio),Immagine linfadenectomia (RR),Immagine uretra (vedi sotto e Pagano 22)
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QUELLE PIU’ FREQUENTIED USUALI SONO:
URETEROCUTANEOSTOMIA URETEROILEOCUTANEOSTOMIA NEOVESCICA ILEALE O COLICA
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Video RR Camey 2
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Schemi miei Camey 2 con Gonaheim
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Video anastomosi ileouretrale (RR-Pagano-altri)
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Video CUM con UDM da Alcini
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