Purpose

To explore the effect of transcatheter arterial embolization (TAE) in controlling intractable, nontraumatic bladder hemorrhage in cancer patients.

Materials and methods

A literature review (PubMed and EMBASE), followed by a retrospective analysis of all cancer patients with intractable hematuria from bladder treated by TAE at our tertiary referral center.

Results

At our institution, 27 consecutive cancer patients who underwent TAE for refractory hematuria from bladder were identified. The systematic review included 13 studies published between 1981 and 2019. In our local cohort, 27 patients were treated with 100% technical success, clinical success in 88.9%, no major complications, and rebleeding rate within the first month of 7.4%. In the systematic review cohort of 201 patients, there was technical success in 99.0%, clinical success in 80.9%, major complications in 5.5%, and a rebleeding rate within the first month of 4.5%. Bilateral embolization was performed in 81.1%, and embolization levels were mostly anterior division of internal iliac artery (73.7%) and vesical artery (23.2%).

Conclusion

TAE is effective and safe to control intractable hematuria from bladder origin in cancer patients after failure of conservative management, providing effective temporary hemostasis. For bladder hemorrhage unsuitable for surgery, TAE should be considered at an early stage.

Secondary abstract

A literature review, followed by retrospective analysis of all patients with intractable hematuria from bladder treated by transcatheter arterial embolization at our tertiary referral center. Transcatheter arterial embolization is effective and safe to control intractable hematuria from bladder. The major complication rate and rebleeding within the first month are acceptable.

中文翻译：

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经导管动脉栓塞治疗癌症患者顽固性，非创伤性膀胱出血：单中心经验和系统评价

目的

探讨经导管动脉栓塞术（TAE）在控制顽固性，非创伤性癌症患者的膀胱出血中的作用。

材料和方法

文献综述（PubMed和EMBASE），然后在我们的三级转诊中心对TAE治疗的所有患有顽固性血尿的膀胱癌患者进行回顾性分析。

结果

在我们的机构中​​，已鉴定出27例因膀胱难治性血尿而接受TAE治疗的连续癌症患者。该系统评价包括1981年至2019年之间发表的13项研究。在我们的本地队列中，有27例患者的技术成功率为100％，临床成功率为88.9％，无重大并发症，并且在第一个月内的再出血率为7.4％。在系统评价的201例患者中，技术成功率为99.0％，临床成功率为80.9％，重大并发症发生率为5.5％，第一个月内的再出血率为4.5％。双边栓塞发生率为81.1％，栓塞水平主要为内动脉前段（73.7％）和膀胱动脉前段（23.2％）。

结论

在保守治疗失败后，TAE对控制癌症患者膀胱源性顽固性血尿有效且安全，可提供有效的暂时止血。对于不适合手术的膀胱出血，应尽早考虑TAE。

次要摘要

文献综述，然后回顾性分析在我们的三级转诊中心经导管动脉栓塞治疗的所有顽固性膀胱血尿患者。经导管动脉栓塞术有效且安全地控制了来自膀胱的顽固性血尿。第一个月内的主要并发症发生率和再出血是可以接受的。