RESUMO
Quality control (QuaCo) in urology is mandatory to standardize or even increase the level of care. While QuaCo is undertaken at every step in the clinical pathway, it should focus on the patient's comorbidities and on the urologist and its complication rate. Resulting from political and economical pressures, comparing QuaCo and outcomes between urologists and institutions is nowadays often performed. However, careful interpretation of these comparisons is mandatory to avoid potential discriminations. Indeed, the reader has to make sure that patients groups and surgical techniques are comparable, definitions of complications are similar, classification of complications is standardized, and finally that the methodology in collecting data is irreproachable.
Assuntos
Garantia da Qualidade dos Cuidados de Saúde , Procedimentos Cirúrgicos Urológicos/normas , Urologia/normas , Humanos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Controle de QualidadeRESUMO
The prognosis of superficial bladder cancer in terms of recurrence and disease progression is related to bladder tumor multiplicity and the presence of concomitant "plane" tumors such as high-grade dysplasia and carcinoma in situ. This study in 33 patients aimed to demonstrate the role of fluorescence cystoscopy in transurethral resection of superficial bladder cancer. The method is based on the detection of protoporphyrin-IX-induced fluorescence in urothelial cancer cells by topical administration of 5-aminolevulinic acid. The sensitivity and the specificity of this procedure on apparently normal mucosa in superficial bladder cancer are estimated to be 82.9% and 81.3%, respectively. Thus, fluorescence cytoscopy is a simple and reliable method for mapping the bladder mucosa, especially in the case of multifocal bladder disease, and it facilitates the screening of occult dysplasia.
Assuntos
Carcinoma de Células de Transição/diagnóstico , Cistoscopia/métodos , Neoplasias da Bexiga Urinária/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Ácido Aminolevulínico/administração & dosagem , Carcinoma de Células de Transição/química , Cistoscópios , Estudos de Avaliação como Assunto , Feminino , Fluorescência , Humanos , Criptônio , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/análise , Protoporfirinas/análise , Sensibilidade e Especificidade , Bexiga Urinária/química , Neoplasias da Bexiga Urinária/química , Urina/citologia , XenônioRESUMO
Day surgery in urology is in full growth actually. The present report is based on our first 120 patients. Low post-operative complication rate, patients' satisfaction and economical savings are the main factors for the important increase in this type of surgery.