Impact of transurethral resection of bladder tumor: analysis of cystectomy specimens to evaluate for residual tumor

Urology ◽  
2004 ◽  
Vol 63 (5) ◽  
pp. 873-877 ◽  
Author(s):  
Sang Eun Lee ◽  
In Gab Jeong ◽  
Ja Hyeon Ku ◽  
Cheol Kwak ◽  
Eunsik Lee ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Residual Tumor

scholarly journals Safety and efficacy of en bloc transurethral resection versus conventional transurethral resection for primary nonmuscle-invasive bladder cancer: a meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Dong Zhang ◽  
Lifeng Yao ◽  
Sui Yu ◽  
Yue Cheng ◽  
Junhui Jiang ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Meta Analysis ◽  
Residual Tumor ◽  
Detrusor Muscle ◽  
En Bloc ◽  
Safety And Efficacy ◽  
Significant Difference ◽  
Bladder Detrusor

Abstract Background The purpose of this meta-analysis is to compare the safety and efficacy of en bloc transurethral resection of bladder tumor (EBRT) versus conventional transurethral resection of bladder tumor (CTURBT). Methods We performed a meta-analysis of relevant articles through November 2019 using PubMed, Embase, and Cochrane Central Register to compare the safety and efficacy of EBRT versus CTURBT. The main endpoint included the operation time (OT), hospitalization time (HT), catheterization time (AT), perioperative period complications, bladder detrusor muscle found in the specimen, the residual tumor on the base, the ratio of the same site recurrence, and 12/24/36-month recurrence rate. Cochrane Collaboration’s Revman software, version 5.3, was used for statistical analysis. Results A total of 19 studies with 2651 patients were included, 1369 underwent EBRT and 1282 underwent CTURBT. Patients treated with EBRT had a significantly lower AT, HT, obturator nerve reflex, bladder perforation, bladder irritation, postoperative complications, and 24-month recurrence rate than those who underwent CTURBT. While no significant difference was found in terms of OT, the ratio of bladder detrusor muscle found in the specimen, the residual tumor on the base, 12-month recurrence rate, 36-month recurrence rate, and the ratio of the same site recurrence. In mitomycin subgroup, EBRT was superior to CTURBT in terms of 12/24-month recurrence rate. Similarly, in the prospective subgroup and retrospective subgroup, EBRT had a lower 24-month recurrence rate than CTURBT. However, no significant difference was found in the low, intermediate, and high-risk group in the light of 12–36-month recurrence rate. Conclusions Based on the included 19 articles, EBRT had a significantly lower AT, HT, intraoperative and postoperative complications, and 24-month recurrence rate than those treated with CTURBT. Well-designed randomized controlled trials were needed to reevaluate these outcomes. Trial registration This meta-analysis was reported in agreement with the PRISMA statement and was registered on PROSPERO 2019 CRD42019121673.

The Result of Re-Transurethral Resection of Bladder Tumor in Eight Years

2021 ◽  
Vol 104 (9) ◽  
pp. 1411-1414
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Residual Tumor ◽  
Pathology Report ◽  
Detrusor Muscle ◽  
Incomplete Resection ◽  
High Grade ◽  
Recurrence Free Survival ◽  
Minor Complication ◽  
Free Survival

Objective: To analyses the residual tumor and staging after transurethral resection of bladder tumor (TURBT). Moreover, to analyze the recurrence and free survival patients who received treatment by re-transurethral resection of bladder tumor (RE-TURBT) and their complications. Materials and Methods: A retrospective study from 35 patients operated by RE-TURBT between January 2010 and December 2018 was done. The patients in the present study were qualified by 1) incomplete resection from the first TURBT, 2) the detrusor muscle did not appear in specimen for high grade transition cell carcinoma, 3) any T1 lesion, or 4) large or multifocal lesion. The analysis of the residual tumor included staging, recurrence-free survival, and complication after RE-TURBT from the pathology report and follow up method. Results: Thirty-five patients were included in this study. The average age of the patients operated by RE-TURBT was 69 years old, with a range of 44 to 87 years old. The presenting symptom was hematuria with gross hematuria in 28 patients (80%) and microhematuria in seven patients (20%). Twenty-five patients (71.4%) were male. The relative factor was smoking in 23 patients (65%) and coexisting with irritative voiding symptom in 11 patients (31.4%). The present study found that there was incomplete resection in 11 patients (31.4%), with under-staging in five patients and incomplete resection in six patients. There were 14 months recurrence-free survival and minor complication in RE-TURBT patients. Conclusion: One third of the patients operated by RE-TURBT had unreasonable staging, especially in Ta high grade staging. This could change the treatment in two patients (5.7%), which found minor complication from RE-TURBT, and improve recurrence-free survival. Keywords: Transurethral resection of bladder tumor (TURBT); Re Transurethral resection of bladder tumor (Re-TURBT)

1881 IMPACT OF FROZEN BIOPSY OF BLADDER TUMOR BED DURING TRANSURETHRAL RESECTION ON RESIDUAL TUMOR AND UPSTAGING AT RETUR

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
JOÃO ALEXANDRE QUEIROZ JUVENIZ ◽  
ADRIANO JOÃO NESRALLAH ◽  
ALEXANDRE CRIPPA SANT'ANNA ◽  
CARLOS HIROKATSU WATANABE SILVA ◽  
CLAUDIO BOVOLENTA MURTA ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Residual Tumor ◽  
Tumor Bed

scholarly journals Differences in Pathologic Results of Repeat Transurethral Resection of Bladder Tumor (TURBT) according to Institution Performing the Initial TURBT: Comparative Analyses between Referred and Nonreferred Group

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hyeong Dong Yuk ◽  
Jung Kwon Kim ◽  
Chang Wook Jeong ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Medical Records ◽  
Bladder Tumor ◽  
Standard Treatment ◽  
Residual Tumor ◽  
Gross Hematuria ◽  
Residual Cancer ◽  
The Mean ◽  
Nonmuscle Invasive Bladder Cancer

Objective. Although transurethral resection of bladder tumor (TURBT) is a standard treatment and determines staging for nonmuscle invasive bladder cancer, many deficiencies persist. There is a risk of upstaging and residual cancer when repeat TURBT is performed. Authors compared the results of repeat TURBT by institution performing the initial TURBT.Methods. We retrospectively reviewed the medical records of 289 patients who underwent repeat TURBT within 2-6 weeks after initial TURBT between 1998 and 2013. The patients were divided into the referred group and the nonreferred group by institution performing the initial TURBT. And we analyzed the intergroup differences in residual tumor and upstaging rate and the factors significantly correlated with residual tumor.Results. The mean age was 69.6 ± 11.1 years and the mean follow-up was 49.7 (range: 0–191) months. The referred group included 69 patients, while the nonreferred group included 220 patients. The referred group included 57 (82.6%) patients with residual tumor after repeat TURBT. Overall upstaging occurred in 15 (21.7%), and upstaging to T2 occurred in 11 (15.9%) of the initial Ta and T1 patients. In the nonreferred group, there were 123 (55.9%) patients with residual tumor. Overall upstaging occurred in 10 (4.5%) and upstaging to T2 occurred in 7 (3.2%) patients.Conclusions. Gross hematuria, grade, and tumor quantity and size were significantly associated with residual cancer on multivariate analysis. In the referred group, repeat TURBT and restaging are necessary.

scholarly journals Utility and Safety of Repeat Transurethral Resection of Bladder Tumor Performed at a Tertiary Center

2020 ◽  
Vol 9 (02) ◽  
pp. 086-089
Author(s):  
Anand Raja ◽  
Kanuj Malik ◽  
Arulmolichelvan Arunandhichelvan ◽  
N. Kathiresan ◽  
L. S. Ravishankar
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Residual Disease ◽  
Residual Tumor ◽  
Disease Recurrence ◽  
Resected Specimen ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Tertiary Center ◽  
The Impact

Abstract Introduction Repeat transurethral resection of bladder tumor (ReTURBT) has become an integral part of the management of superficial bladder cancers at various urological centers around the world. Early detection of residual disease, leading to upstaging in some cases, leads to decrease in recurrence rates. Our study aimed to analyze the impact of ReTURBT in detecting residual tumor and tumor recurrences, hence validating the benefits of procedure as a routine. Materials and Methods A total of 152 patients with superficial bladder cancer who were treated at Cancer Institute (WIA) between January 2005 and December 2013 were analyzed and followed up for 3 years. Results Of the 152 cases who underwent ReTURBT, 47 patients had residue in the final histopathology of the resected specimen (31%). The overall rate of upstaging to muscle-invasive disease following ReTURBT was 3.3%. The mean follow-up period was 47.13 months, during which 25 (17%) out of 147 patients who underwent ReTURBT had disease recurrence. There was no additional morbidity due to ReTURBT as compared with the primary procedure. Conclusion ReTURBT is an effective procedure in treating recurrent tumors also as long as they remain superficial. The procedure when performed with utmost care in experienced hands remains a very safe procedure to be followed as a routine and standard.

Deciding When to Omit Repeat Transurethral Resection of Superficial Bladder Cancer: Do Photodynamic Diagnostics help?

2020 ◽  
Vol 6 (4) ◽  
pp. 489-496
Author(s):  
Eva Sailer ◽  
Frens-Steffen Krause ◽  
Volkmar Tauber ◽  
Wolfgang Schimetta ◽  
Sebastian Alfred Graf
Keyword(s):  
Transurethral Resection ◽  
Tumor Size ◽  
Bladder Tumor ◽  
Superficial Bladder Cancer ◽  
Residual Tumor ◽  
Current Evidence ◽  
Short Term ◽  
Repeat Resection ◽  
Photodynamic Diagnostics ◽  
Initial Resection

BACKGROUND: Repeat transurethral resection of bladder tumor is recommended when certain risk constellations are present on initial resection. Current evidence is conflicting, leading to dissenting recommendations in multinational guidelines around the world. Photodynamic diagnostics (PDD) is a tool which has been shown to increase diagnostic accuracy, but evidence is still lacking if this may permit omission of repeat resections in certain cases. OBJECTIVE: To evaluate whether the use of photodynamic diagnostics has an impact on resection quality and residual tumor rate, and to explore which parameters may have an impact on the necessity of repeat transurethral resections. METHODS: We retrospectively evaluated 373 patients in the timeframe of ten years, in whom a repeat transurethral resection of bladder tumor has been performed following initial resection at our department. About half of those resections were performed using photodynamic diagnostics. RESULTS: When PDD was used, more tumor mass was revealed and resected, but the shown trend toward a lower residual tumor rate was non-significant. Muscularis was shown more often on PDD resections. While being a rare occurrence, upstaging on repeat resection happened significantly less often after initial PDD use. Furthermore, tumor size and multifocality significantly influenced residual tumor rate in Ta high-grade stage. CONCLUSIONS: PDD use may lead to a more accurate initial staging but this may not have an impact on short-term residual tumor rate. Tumor size and multifocality should be granted more weight in the decision-making process as when to perform a repeat resection.

scholarly journals Safety and efficacy of en bloc transurethral resection versus conventional transurethral resection for primary nonmuscle-invasive bladder cancer：a meta-analysis

2019 ◽  
Author(s):  
dong zhang ◽  
lifeng yao ◽  
sui yu ◽  
yue cheng ◽  
junhui jiang ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Meta Analysis ◽  
Residual Tumor ◽  
Detrusor Muscle ◽  
En Bloc ◽  
Safety And Efficacy ◽  
Significant Difference ◽  
Bladder Detrusor

Abstract Abstract Background: The purpose of this meta-analysis is to compare the safety and efficacy of en bloc transurethral resection of bladder tumor（EBRT） versus conventional transurethral resection of bladder tumor（CTURBT）. Methods: We performed a meta-analysis of relevant articles through January 2019 using PubMed, Embase and Cochrane Central Register to compare the safety and efficacy of EBRT versus CTURBT. The main endpoint included the operation time（OT）, hospitalization time（HT）, catheterization time（AT），perioperative period complications, bladder detrusor muscle found in the specimen, the residual tumor on the base, the ratio of the same site recurrence and 12/24/36-month recurrence rate. Cochrane Collaboration’s Revman software, version 5.3, was used for statistical analysis. Results: A total of 19 studies with 2651 patients were included，1369 underwent EBRT and 1282 underwent CTURBT. Patients treated with EBRT had a significantly lower AT, HT, obturator nerve reflex, bladder perforation, bladder irritation, postoperative complications and 24-month recurrence rate than those who underwent CTURBT. While no significant difference was found in terms of OT, the ratio of bladder detrusor muscle found in the specimen, the residual tumor on the base, 12-month recurrence rate, 36-month recurrence rate and the ratio of the same site recurrence. In mitomycin subgroup, EBRT was superior to CTURBT in terms of 12/24-month recurrence rate. Similarly, in the prospective subgroup and retrospective subgroup, EBRT had a lower 24-month recurrence rate than CTURBT. However, no significant difference was found in the low, intermediate and high-risk group in the light of 12-36 month recurrence rate. Conclusions: Based on the included 19 articles, EBRT had a significantly lower AT, HT, intraoperative and postoperative complications and 24-month recurrence rate than those treated with CTURBT. Well designed randomized controlled trials were needed to reevaluate these outcomes. Trial registration: This meta-analysis was reported in agreement with the PRISMA statement and was registered on PROSPERO 2019CRD42019121673. Keywords: bladder tumor; en bloc transurethral resection; conventional transurethral resection of bladder tumor; meta-analysis; complication

Comparison of Endoscopic Versus Percutaneous Approach (Blind) to Control the Obturator Jerk in Patients Undergoing Transurethral Resection of Bladder Tumors Under Spinal Anesthesia

2020 ◽  
Vol 21 (2) ◽  
pp. 120-126
Author(s):  
Alamgir Md ◽  
Karim Km Monwarul ◽  
Nandy SP ◽  
Md Monwar Ul Haque ◽  
Sakhawat Mahmud Khan
Keyword(s):  
Statistical Analysis ◽  
Spinal Anesthesia ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Complete Resection ◽  
Satisfaction Level ◽  
Bladder Tumors ◽  
Percutaneous Approach ◽  
Group A ◽  
Group B

Objective: The aim of the study was to compare the endoscopic versus percutaneous approach (blind) to control the obturator jerk in patients undergoing transurethral resection of bladder tumors under spinal anesthesia. Materials and methods: A prospective observational study was performed in Department of Urology, Chittagong Medical College, Chittagong and some Private Hospitals (Ltd.) in Chittagong city during the period from January 2016 to June 2016. Total 100 patients were grouped into two, on alternate basis. Fifty(50) patients in group- A conducted with endoscopic infiltration with 20ml of injection 2% lignocaine at the bladder tumor base and another 50 patients in group-B, conducted with blind percutaneous technique with same drug and volume ( 20ml inj.2% lignocaine) to control obturator jerk. Severity of obturator jerk in both procedure, percentage of complete resection, ONB procedure related time, ONB procedure related complications and surgeon’s satisfaction level were recorded and compared between two approaches. Chi-square analysis was performed to compare the ease of approach and outcome of the two techniques. A value of P<0.05 was considered statistically significant. Results: The mean age of the patients were 59.44+7.681. In group-A, 50 patients were given inj. 2% lignocaine endoscopically at the bladder tumor base to control obturator jerk. Twenty five patients (50%) had no jerk, 20 patients(40%) developed mild jerk and 5 patients (10%) developed moderate jerk and no patients developed severe jerk. Second attempt was taken in moderate jerk patients (5 patients) and succeeded in 3(6%) patients. So, in this group, complete resection of bladder tumor was possible in 96%. In group B, complete resection of bladder tumor was possible in 84%. Statistical analysis was done and result is significant in case of endoscopic procedure to control obturator jerk(p<0.05). ONB Procedure related time was <20 mins. in 32(64%) patients in group-A and 45 (90%) patients in group- B. 20 mins. or more time was required for 18 (36%) patients in group-A and 5 (10%) patients in group-B. Statistical analysis was done and result is significant in percutaneous (blind) technique (p<0.05). ONB procedure related complications in group-A and Group –B were noted. Statistical analysis was done and result is insignificant (p>0.05). Surgeons satisfaction level were recorded on the basis of obturator jerk block and complete resection and which was statistically significant in favour of endoscopy group (p<0.05). Conclusion: It is concluded that endoscopic injection of 2% lignocaine into the bladder tumor base is better in case of jerk elimination and complete resection than blind percutaneous approach. Though, ONB procedure related time was significantly less in percutaneous group. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.120-126

En bloc transurethral resection of bladder tumor: A review of the literature

2021 ◽  
pp. 205141582199373
Author(s):  
Jonathan Kopel ◽  
Pranav Sharma
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Clinical Stage ◽  
Surgical Techniques ◽  
Cancer Recurrence ◽  
En Bloc ◽  
Level Of Evidence ◽  
Alternative Technologies ◽  
Bladder Cancer Recurrence

Bladder cancer remains one of the most common malignancies of the genitourinary tract. Transurethral resection of the bladder tumor (TURBT) via cystoscopy with examination under anesthesia remains the primary method for determining the diagnosis and clinical stage of bladder cancer. Given the substantial cost of treatment and risk of bladder cancer recurrence after TURBT, novel approaches to transurethral resection, such as the en bloc technique, have been developed in an attempt to address these limitations. In this review, we examined the postoperative and oncological outcomes of en bloc TURBT compared to traditional resection techniques. Further prospective clinical studies, however, are still necessary to determine whether these alternative technologies or surgical techniques may improve treatment in bladder cancer patients. Level of evidence: Not applicable.

Sign in / Sign up

Export Citation Format

Share Document