En bloc transurethral resection of bladder tumors: use and limits

Urology ◽  
2003 ◽  
Vol 62 (6) ◽  
pp. 1089-1091 ◽  
Author(s):  
Michele Lodde ◽  
Lukas Lusuardi ◽  
Salvatore Palermo ◽  
Diego Signorello ◽  
Klaus Maier ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumors ◽  
En Bloc

scholarly journals ANALYSIS OF ENDOUROLOGICAL TREATMENT TECHNIQUES OF URINARY BLADDER TUMORS

InterConf ◽  
2021 ◽  
pp. 290-298
Author(s):  
Ivan Vladanov ◽  
Alexei Plesacov ◽  
Vitalii Ghicavii
Keyword(s):  
Urinary Bladder ◽  
Transurethral Resection ◽  
Standard Technique ◽  
Tumor Stage ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Diagnosis And Treatment ◽  
Bladder Tumors ◽  
En Bloc ◽  
Treatment Techniques

Transurethral resection is very important not only for diagnosis and treatment of NMIBC, but also for its management. The application field of transurethral resection includes establishing histological diagnosis, determination of prognostic factors including the tumor stage, complete resection of all detected tumors of urinary bladder. Transurethral resection of bladder tumor (TURBT) is the standard technique for the diagnosis and treatment of non-muscle invasive bladder cancer. This method has also some limitations. One of the limitations is the insufficient assessment of the resection depth. It leads to the necessity of intravesical tumor fragmentation, but its disadvantage is that it limits the histopathological evaluation. In order to improve the treatment outcome for patients with non-muscular invasive bladder tumors, several new techniques such as En-bloc resection were proposed.

En Bloc Transurethral Resection of Bladder Tumors: A New Standard?

2017 ◽  
Vol 31 (S1) ◽  
pp. S-20-S-24 ◽  
Author(s):  
Angelo Naselli ◽  
Paolo Puppo
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumors ◽  
En Bloc

scholarly journals En Bloc Resection of Bladder Tumor—Is It the Way Forward?

2021 ◽  
Vol 8 ◽  
Author(s):  
Christian Daniel Fankhauser ◽  
Marian Severin Wettstein ◽  
Luca Afferi ◽  
Nico Christian Grossmann ◽  
Hugh Mostafid
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
80 And Over ◽  
Bladder Tumors ◽  
En Bloc ◽  
Translational Studies

Transurethral resection of bladder tumors (TURBT) represents the cornerstone in diagnosis and treatment of bladder cancer but recurrence is observed in up to 80% and over- or understaging with TURBT is common. A more recent development to overcome these limitations represents en-bloc resection of bladder tumors (ERBT) which offers several advantages over TURBT. In this report, we briefly review studies assessing outcomes of bladder cancer patients undergoing ERBT. Most randomized and non-randomized trial demonstrate improvement in clinical outcomes for ERBT over TURBT, however more pathological and translational studies are warranted.

scholarly journals En bloc transurethral resection of bladder tumors: A review of current techniques

2021 ◽  
Vol 16 (5) ◽  
Author(s):  
Stefanie M. Croghan ◽  
Niall Compton ◽  
Rustom P. Manecksha ◽  
Ivor M. Cullen ◽  
Pádraig J. Daly
Keyword(s):  
Transurethral Resection ◽  
Residual Disease ◽  
Laser Energy ◽  
Sampling Rate ◽  
Obturator Nerve ◽  
Current Evidence ◽  
Energy Sources ◽  
Detrusor Muscle ◽  
Bladder Tumors ◽  
En Bloc

Introduction: Growing interest surrounds the concept of en bloc transurethral resection of bladder tumors (ERBT). Theoretical advantages include improved adherence to oncological principles and potential yield of superior pathological specimens. Multiple ERBT methods exist. This review summarizes the current evidence regarding application of differing techniques and technologies to ERBT. Methods: A systematic review of MEDLINE/EMBASE/Scopus databases was performed, using terms “en bloc,” “ERBT,” “bladder,” and “urinary bladder neoplasm.” Template-based data extraction included technique of ERBT, feasibility, tumor size, activation of obturator nerve reflex, operative complications, detrusor muscle sampling rate, and recurrence data. Results: Multiple approaches to ERBT have evolved, using a variety of energy sources. The feasibility of electrocautery, laser, combined waterjet/electrocautery, and polypectomy snare techniques have been confirmed in achieving ERBT. ERBT appears safe, with a low complication rate. The use of laser energy sources reduces the risk of activating the obturator nerve reflex during lateral wall resections. Otherwise, no energy source is unequivocally superior in achieving ERBT. The rate of detrusor muscle sampling is high with use of ERBT and appears superior to that achieved with conventional TURBT (cTURBT) in multiple comparative studies. A limited number of largely non-randomized trials assess bladder tumor recurrence; current evidence suggests this is similar between ERBT and cTURBT groups. Conclusions: En bloc resection of bladder tumors using a variety of technologies is feasible and safe, with a high detrusor muscle sampling rate. Further research is required to determine whether rates of residual disease or recurrence can be reduced with ERBT vs. cTURBT.

scholarly journals Comparative analysis between En-bloc resection and transurethral resection of non-muscular invasive bladder tumors

2021 ◽  
Vol 64 (2) ◽  
pp. 65-69
Author(s):  
Ivan Vladanov ◽  
◽  
Alexei Plesacov ◽  
Vitalie Ghicavii ◽  
◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Correct Diagnosis ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Detrusor Muscle ◽  
Bladder Tumors ◽  
En Bloc ◽  
Resection Group ◽  
Muscle Invasive

Background: Transurethral resection of the bladder (TURB) tumor was first described by Stern and McCarthy in 1931, and is still considered the gold standard in diagnosis and treatment of non-muscle-invasive bladder cancer. The quality of TURB affects accuracy of histopathologic evaluation, and subsequently impacts the risk of recurrence and patient outcome. New methods that aim to improve the effectiveness of TURB are reviewed, and recent studies are discussed, including resection methods and image enhancement techniques. Material and methods: Between January 2016 and April 2019, within the Urology Clinic of Nicolae Testemitanu State University of Medicine and Pharmacy 108 patients were surgically treated with bladder tumor pathology. Patients were divided in two groups: En-bloc resection group which includes 51 patients and transurethral resection group with 57 patients, the obtained data were comparatively analyzed. Results: Tumor analysis showed that the majority of the patients’ tumors were localized on lateral urinary bladder walls, single bladder tumors were detected in 64 (59%) cases, tumor sizes up to 3 cm were detected in 74 (69%) patients included in the study. Detrusor muscles were detected in 49 (96%) cases of En-bloc group and 45 (79%) cases of TURB group. Most recurrences occurred in patients with high-grade histological result, recurrence rate in En-bloc group occurred in 18% and in TURB group in 37%. Conclusions: The En-bloc resection technique of non-muscle-invasive bladder tumor proved to be a safe and effective method compared to the conventional transurethral resection technique (TURB). This method provides more favorable results for obtaining better quality tumor samples (present of detrusor muscle) that allow to establish correct diagnosis and staging of the disease and reduces the number of recurrences.

scholarly journals Endourological treatment of non-muscular-invasive bladder tumors

2021 ◽  
Vol 64 (5) ◽  
pp. 33-37
Author(s):  
Ivan Vladanov ◽  
Keyword(s):  
Transurethral Resection ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Characteristic Size ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Bladder Tumors ◽  
En Bloc ◽  
Size Number ◽  
Different Types

Background: Transurethral resection of the bladder is one of the essential methods in the diagnosis, treatment and management of non-muscularinvasive bladder cancer. The purpose of the procedure is to remove completely all visually detected tumors with a following establishment of a very precise histological diagnosis. The aim of the study is to compare the results of conventional transurethral endoscopic treatment and the En-bloc resection method using different types of energy sources in the treatment of bladder tumors. Material and methods: A total number of 88 patients underwent endourological interventions. Regarding the distribution, 23 patients had conventional transurethral resection, 22 – En-bloc monopolar resection, 21 – En-bloc bipolar resection and 22 – En-bloc with Thu:YAG laser. Clinical data, intraoperative and postoperative data and also the histopathological examination results were compared. Results: The compared groups were heterogeneous by age, sex, tumor characteristic (size, number, location). No significant differences were observed during the operations, comparing the intraoperative and postoperative complications of the studied groups. The detrusor musculature was detected in 74% of cases after conventional transurethral resection, in 91% of cases of En-bloc monopolar resection, in 95% of cases of En-bloc bipolar resection and in 96% of cases of En-bloc Thu:YAG laser. Conclusions: The En-bloc resection technique of non-muscular-invasive bladder tumors is a safe and effective method comparing with the conventional transurethral resection; it allows more favorable postoperative results and obtaining better quality tumor samples which allow establishing correct diagnosis of the disease.

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