In recent years, the incidence of bladder cancer is particularly high in China, and resection and radiotherapy are the common treatments for this disease, in addition to interventional therapies that can also be used in the diagnosis and treatment of bladder cancer. Interventional therapy is a newly developed treatment modality that has a special role in the treatment of cancer. Some patients with bladder cancer are unfavorable for immediate surgery due to late detection and large tumor; some patients cannot have surgery due to other physical limitations; or some patients are unwilling to have surgery, they can use interventional therapy as an adjuvant treatment.
Interventional treatment for bladder cancer mainly involves infusion of chemotherapy drugs through bladder artery and super-selective embolization of tumor supply artery, also called percutaneous selective arterial intervention, which can kill cancer cells by increasing the local drug concentration and embolization of tumor supply artery. Since the drug concentration is increased locally, it can not only improve the local efficacy but also reduce the systemic drug response.
Indications for interventional treatment of bladder cancer 1. Any case ready for surgical resection can be treated with interventional treatment before surgery.
2.Bladder cancer that cannot be removed by surgery.
3.Bladder cancer that recurs after surgery.
4.Bladder cancer with uncontrollable bleeding.
Contraindications to interventional treatment of bladder cancer Generally, there are no special contraindications. Severe hepatic, renal and cardiac insufficiency and iodine allergy are not recommended.
Steps of Interventional Treatment for Bladder Cancer 1.After local anesthesia, the femoral artery is punctured and the tip of the catheter is placed in the 4th lumbar plane for diagnostic imaging of the lower abdominal aorta. The commonly used chemotherapeutic agents are cisplatin (30 mg), 5-fluorouracil (1 g), mitomycin (1O mg), and embolization agents are autologous blood clots, gelatin sponges and spiroloops.
Complications of interventional therapy for bladder cancer and its management 1.There are generally no serious complications, even if they appear the same as general angiography.
2.Embolization of the internal skeletal artery, a numbness and swelling of the buttocks may occur, which usually disappears after 5-6 days.
Nursing care of interventional combined surgical treatment for bladder cancer Psychological care For patients who receive interventional treatment for the first time, there are different degrees of fear and anxiety psychology due to the lack of interventional knowledge and also considering the treatment effect and operation cost. For patients who are worried about the success of interventional treatment and the occurrence of complications, we will introduce the procedure, method and various safety measures in detail, explain the safety and reliability of the procedure, eliminate their fears, and make the patients establish the confidence to overcome the disease. The patient should have the confidence to overcome the disease and cooperate with the treatment actively so that the operation can be carried out smoothly.
Pre-operative care Cooperate with the physician to improve the laboratory tests and notify the doctor in charge of any missed tests or abnormalities in a timely manner. Prepare the skin carefully 1 d before surgery. The skin preparation for trans-femoral artery puncture should be done from the top to the flat umbilicus, from the bottom to the outer third of the thigh, and from both sides to the mid-axillary line. The skin preparation should be done bilaterally so that the opposite side can be replaced when one side is difficult to be cannulated, and the patient should be assisted to clean the skin. Do allergy test of pantothenic glucosamine and antibiotics 24 hours before surgery. In the morning of the operation, the patient can be asked to eat a small amount of liquid diet to avoid complications such as vomiting caused by intraoperative chemotherapy or hypoglycemia caused by eating too little.