Are urological tumors suitable for minimally invasive treatment?

  Urology is a specialized discipline that studies and treats diseases of the urinary system (including the kidneys, ureters, bladder, and urethra), the male reproductive system, and adrenal surgery. Over the course of life, tumors can develop in these genitourinary organs. With the change of lifestyle and the prolongation of human life, at present, various types of tumors have become common diseases in domestic medical clinics, and urological tumors are no exception, and the incidence rates are from high to low: bladder cancer, kidney cancer, adrenal tumors, prostate cancer, epithelial tumors of the upper urinary tract, etc., and the incidence rates are all on a significant increase. It has been reported that the new incidence rate of prostate cancer in Shanghai, China has ranked first among genitourinary tumors and is gradually approaching the level of Europe and America; bladder cancer is the male genitourinary tumor with the highest incidence rate in China; kidney cancer is also one of the diseases that seriously endanger human health, accounting for about 2% to 3% of adult malignant tumors. Among these tumors, except for prostate cancer, which is concentrated in the age of 60 to 80, others are mostly concentrated in the age of 30 to 80.  Although the treatment of tumors is still an international challenge, some tumors are curable and have a good prognosis, depending on the location and period of onset as well as the benign and malignant nature of the tumor. Once urological tumors are detected, surgical resection should be the main treatment, and other treatments should be supplemented according to the pathological examination results. As long as there are indications for surgery, surgery should be performed as soon as possible.  With the development of minimally invasive urology, minimally invasive treatment of urological tumors has been playing its great role more and more. The effect of minimally invasive surgery for urological tumors has been recognized by the international medical community and has been standardized in developed countries. Although minimally invasive surgery has been carried out in China for many years, most people still do not know much about it. “My family member was found to have kidney cancer, should we do open surgery or minimally invasive surgery?” In hospital urology departments, patients or family members often ask doctors this.  Why is urological tumor also suitable for minimally invasive treatment?  The major difference between the urological system and other systems is that it is not a closed system. The organs of the urological system leave the same portal as the outside world when discharging the excess water and metabolites from the body. On the other hand, the peritoneum in the body is like a “screen” separating the abdominal cavity from the posterior abdominal cavity, and most of the organs of the urinary system are located in the posterior abdominal cavity behind the “screen” or the “screen The pelvic cavity below the “screen”. These two characteristics make the urology department have unique advantages in carrying out minimally invasive surgery: a. Using natural human cavities such as urethra and ureter: transurethral resection of bladder tumor (TURBt) not only has the advantages of less damage and faster recovery, but also will not cause tumor implantation in the abdominal wall, and repeated surgery will not increase the difficulty, which is suitable for fine tissues, superficial and low grade bladder tumors; transurethral ureteral rigid mirror and soft mirror can be used to treat ureteral tumors. It is suitable for fine tipped, superficial and low grade bladder tumors. These procedures do not leave any scars, and the cavernous urologist can chant in style after the surgery: “Quietly I go, as I came quietly, waving a hand without leaving a trace.  Second, in the posterior abdominal cavity or pelvic “independent kingdom” surgery: laparoscopic surgery is a new means of treatment that has emerged in recent years, characterized by small trauma, fast recovery, especially with the role of field of view magnification, making the more difficult surgery easier, suitable for some of the more delicate operations, and relatively small impact on the organs of the abdominal cavity. The impact on the organs in the abdominal cavity is relatively small. Major surgeries such as nephrectomy, radical nephrectomy, partial nephrectomy, adrenal tumor resection, total cystectomy, and radical prostate cancer surgery, which could only be done with open surgery in the past, have become routine laparoscopic or retrolaparoscopic procedures.  Some patients may think that open surgery is thorough, clean and not easy to recur, and worry that minimally invasive surgery cannot do this. In fact, this is a complete misunderstanding. All minimally invasive surgery must be based on the premise of efficacy, and minimally invasive urology is no exception, and it is because of the exact efficacy that it has a strong vitality and strong momentum. Compared with open surgery, minimally invasive surgery has a small incision but an open field of vision. In open surgery, the doctor observes the lesion at the tumor site through the naked eye, but minimally invasive surgery is performed under a magnifying glass, and the doctor can see the lesion site magnified several times, allowing for a more precise resection. For malignant tumors, surgery is not simply to cut off the tumor site or a certain organ, but to clean up the tissue area where cancer cells may spread, like lymph nodes and blood vessels, to achieve the purpose of tumor eradication. And to achieve this effect obviously minimally invasive surgery is much more convenient than open surgery. Many patients may also think that minimally invasive urological surgery is expensive, but in fact, the total hospitalization cost for most patients does not increase compared to open surgery because of the short hospitalization time for this surgical treatment. In addition, patients who undergo the procedure are able to return to their normal lives and work sooner because the length of stay for treatment and the recovery time from surgical trauma are greatly reduced. Therefore, patients actually gain greater benefits from it.  Overall, minimally invasive treatment for urological tumors has the following advantages: less trauma, only a very small incision on the body surface or no incision is needed, fast recovery; exact local efficacy; can play a radical role in early tumors. It is accurate in positioning, selective and can protect normal tissue and organ functions to the maximum. Because of these advantages, minimally invasive treatment has become an indispensable and important element in the comprehensive treatment of urological tumors. Therefore, minimally invasive treatment for urological tumors is a good choice as long as the surgical indications are well mastered and the surgeon can perform the operation skillfully.