{"id":12816,"date":"2025-08-05T09:49:27","date_gmt":"2025-08-05T13:49:27","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/radical-cystectomy\/"},"modified":"2025-08-05T09:49:27","modified_gmt":"2025-08-05T13:49:27","slug":"cistectomia-radical-pt-br","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/cistectomia-radical-pt-br\/","title":{"rendered":"Cistectomia Radical"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[112],"glossary-product":[],"class_list":["post-12816","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-surgical-procedures"],"acf":{"gt-definition":"

Cistectomia radical \u00e9 um procedimento cir\u00fargico que envolve a remo\u00e7\u00e3o completa da bexiga urin\u00e1ria e \u00f3rg\u00e3os adjacentes para tratar o c\u00e2ncer de bexiga.1<\/sup> Em pacientes do sexo masculino, isso normalmente inclui a remo\u00e7\u00e3o da pr\u00f3stata e das ves\u00edculas seminais, enquanto em pacientes do sexo feminino, pode incluir a remo\u00e7\u00e3o do \u00fatero, ov\u00e1rios, trompas de fal\u00f3pio e parte da parede vaginal anterior.2<\/sup> O procedimento tamb\u00e9m comumente envolve a remo\u00e7\u00e3o de g\u00e2nglios linf\u00e1ticos regionais (p\u00e9lvicos). linfadenectomia) para avaliar a propaga\u00e7\u00e3o do c\u00e2ncer e melhorar os resultados oncol\u00f3gicos.3<\/sup> Ap\u00f3s a remo\u00e7\u00e3o da bexiga, um procedimento de deriva\u00e7\u00e3o urin\u00e1ria \u00e9 realizado para criar um novo caminho para a urina sair do corpo.4<\/sup> A cistectomia radical \u00e9 considerada uma das t\u00e9cnicas cir\u00fargicas mais desafiadoras em urologia e representa o tratamento padr\u00e3o para c\u00e2ncer de bexiga m\u00fasculo-invasivo (MIBC) na aus\u00eancia de doen\u00e7a metast\u00e1tica.5<\/sup><\/p>\n

A cistectomia radical \u00e9 a remo\u00e7\u00e3o cir\u00fargica completa da bexiga, juntamente com os tecidos adjacentes. No homem, inclui remo\u00e7\u00e3o da pr\u00f3stata e ves\u00edculas seminais; na mulher, pode incluir \u00fatero, ov\u00e1rios e parede anterior da vagina. \u00c9 o tratamento padr\u00e3o-ouro para o c\u00e2ncer de bexiga m\u00fasculo-invasivo e para tumores superficiais de alto risco refrat\u00e1rios \u00e0 BCG, conforme as diretrizes da EAU.<\/p>","gt-synonyms":"Cistectomia completa, Cistectomia total, Cirurgia radical de remo\u00e7\u00e3o da bexiga, RC","gt-citation":"[1] Aminoltejari K, Black PC. Radical cystectomy: a review of techniques, developments and controversies. Transl Androl Urol. 2020 Dec;9(6):3073-3081. DOI: 10.21037\/tau.2020.03.23\n\n[2] Afak YS, Wazir BS, Hamid A, Wani MS, Aziz R. Comparative Study of Various Forms of Urinary Diversion after Radical Cystectomy in Muscle Invasive Carcinoma Urinary Bladder. Int J Health Sci (Qassim). 2009 Jan;3(1):3-11. PMID: 21475504\n\n[3] McGuire MS, Grimaldi G, Grotas J, Russo P. The type of urinary diversion after radical cystectomy significantly impacts on the patient's quality of life. Ann Surg Oncol. 2000 Jan-Feb;7(1):4-8. DOI: 10.1007\/s10434-000-0004-2\n\n[4] National Cancer Institute. Definition of radical cystectomy - NCI Dictionary of Cancer Terms. https:\/\/www.cancer.gov\/publications\/dictionaries\/cancer-terms\/def\/radical-cystectomy\n\n[5] Mayo Clinic. Bladder removal surgery (cystectomy). https:\/\/www.mayoclinic.org\/tests-procedures\/cystectomy\/about\/pac-20385108","gt-clinical-context":"

A cistectomia radical \u00e9 indicada principalmente para o tratamento do c\u00e2ncer de bexiga m\u00fasculo-invasivo (est\u00e1gios T2-T4a).1<\/sup> Tamb\u00e9m \u00e9 recomendada para c\u00e2ncer de bexiga n\u00e3o invasivo muscular de alto risco que n\u00e3o responde \u00e0 terapia intravesical (como o tratamento com BCG), particularmente em casos de tumores T1 de alto grau ou carcinoma in situ (CIS) que persistem ou recorrem ap\u00f3s tratamento adequado. tratamento.2<\/sup><\/p>\n \n

A sele\u00e7\u00e3o de pacientes para cistectomia radical envolve uma considera\u00e7\u00e3o cuidadosa do est\u00e1gio da doen\u00e7a, do estado geral de sa\u00fade e das prefer\u00eancias do paciente.3<\/sup> A abordagem de tratamento ideal para c\u00e2ncer de bexiga invasivo muscular n\u00e3o metast\u00e1tico geralmente consiste em quimioterapia neoadjuvante \u00e0 base de cisplatina seguida de cistectomia radical com dissec\u00e7\u00e3o de linfonodos p\u00e9lvicos.4<\/sup> Para pacientes selecionados, a terapia trimodal (ressec\u00e7\u00e3o transuretral m\u00e1xima seguida de quimiorradia\u00e7\u00e3o) pode ser considerada uma abordagem alternativa de preserva\u00e7\u00e3o da bexiga, embora a cistectomia radical continue sendo uma op\u00e7\u00e3o para terapia de resgate se esta abordagem falhar.5<\/sup><\/p>\n \n

O procedimento cir\u00fargico pode ser realizado usando t\u00e9cnicas abertas, laparosc\u00f3picas ou assistidas por rob\u00f4, embora as taxas de complica\u00e7\u00f5es e a morbidade permane\u00e7am significativas, independentemente da abordagem.6<\/sup> Ap\u00f3s a remo\u00e7\u00e3o da bexiga, a deriva\u00e7\u00e3o urin\u00e1ria \u00e9 necess\u00e1ria, com op\u00e7\u00f5es que incluem conduto ileal (mais comum), bolsa cut\u00e2nea continente (como a bolsa de Indiana) ou reconstru\u00e7\u00e3o ortot\u00f3pica da neobexiga.7<\/sup> Cada tipo de deriva\u00e7\u00e3o tem vantagens e desvantagens espec\u00edficas, e a sele\u00e7\u00e3o depende de fatores do paciente, caracter\u00edsticas da doen\u00e7a e experi\u00eancia do cirurgi\u00e3o.8<\/sup><\/p>\n \n

Os cuidados p\u00f3s-operat\u00f3rios concentram-se no gerenciamento de complica\u00e7\u00f5es, que podem incluir sangramento, infec\u00e7\u00e3o, m\u00e1 cicatriza\u00e7\u00e3o de feridas, obstru\u00e7\u00e3o intestinal e dist\u00farbios metab\u00f3licos.9<\/sup> O acompanhamento de longo prazo \u00e9 essencial para monitorar a recorr\u00eancia do c\u00e2ncer, avaliar a fun\u00e7\u00e3o renal e abordar quest\u00f5es de qualidade de vida relacionadas \u00e0 deriva\u00e7\u00e3o urin\u00e1ria.10<\/sup><\/p>\n

A EAU 2023 recomenda cistectomia radical com linfadenectomia p\u00e9lvica estendida como padr\u00e3o. Quimioterapia neoadjuvante baseada em cisplatina \u00e9 indicada antes da cirurgia em pacientes eleg\u00edveis. A reconstru\u00e7\u00e3o inclui neobexiga ortot\u00f3pica (preserva\u00e7\u00e3o da contin\u00eancia), conduto ileal (Bricker) ou deriva\u00e7\u00e3o continente. A cirurgia rob\u00f3tica est\u00e1 se tornando padr\u00e3o em centros especializados, com resultados compar\u00e1veis \u00e0 abordagem aberta.<\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":50},"yoast_head":"\nCistectomia Radical: Cirurgia para C\u00e2ncer de Bexiga | Rigicon<\/title>\n<meta name=\"description\" content=\"Guia sobre cistectomia radical: indica\u00e7\u00f5es no c\u00e2ncer de bexiga, t\u00e9cnica cir\u00fargica, linfadenectomia e deriva\u00e7\u00e3o urin\u00e1ria. 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