Bladder cancer is one of the most common tumors in urology in China, a disease that directly threatens the survival of patients and can occur at any age. The incidence of bladder cancer in China ranks seventh among all malignant tumors in men and after tenth in women. Two of the more obvious risk factors for bladder cancer are smoking and long-term exposure to industrial chemical products. Smoking is the most certain risk factor for bladder cancer, about 30%~50% of bladder cancer is caused by smoking, and smoking can increase the risk rate of bladder cancer by 2~4 times, and the risk rate is proportional to the intensity and duration of smoking.
Hematuria is a common symptom of bladder cancer, especially interstitial whole painless carnal hematuria. Of course, bladder cancer also has frequency, urgency and painful urination as its main manifestations, and such symptoms are often associated with diffuse carcinoma in situ or invasive bladder cancer. Other symptoms include back pain due to ureteral obstruction, edema of lower limbs, pelvic mass, etc. Therefore, once the above symptoms occur, especially painless hematuria, one should be alert to the possibility of bladder cancer and should go to a hospital urologist in time.
Once bladder cancer is diagnosed, surgery should be performed in time. Surgical methods include: ① local resection of tumor: transurethral resection of bladder tumor (commonly used are common electrodesis, plasma electrodesis, etc.) is still the main treatment method for bladder cancer. Since there is no significant difference between the efficacy of open partial cystectomy and transurethral resection of bladder tumor, it is not advisable to choose open partial cystectomy except for very few patients such as isolated, low-grade bladder diverticulum tumor. ②Total cystectomy: Total cystectomy includes two surgical procedures: open total cystectomy and laparoscopic total cystectomy. In recent years, with the clinical application of high-definition TV laparoscopic surgery system in our urology department, the author took the lead in successfully carrying out laparoscopic total cystectomy in a local municipal hospital based on the experience of routinely carrying out open total cystectomy, radical prostate cancer treatment, and more than 1000 cases of laparoscopic urology surgery. Since laparoscopy has the advantages of multi-angle observation and magnification of the surgical field, precise surgical operation, careful separation of anatomy, which can reduce intraoperative bleeding and injury, and fewer complications, laparoscopic total cystectomy has the advantages of clear surgical field, less surgical trauma, less bleeding, less pain, faster postoperative recovery, and beautiful incision compared with open total cystectomy. The operation time is similar to that of open surgery.