Closed-loop audit of muscle sampling in Trans-Urethral Resection of Bladder Tumour

2021 ◽  
pp. 205141582110499
Author(s):  
Raghav Varma ◽  
Abdalla Deb ◽  
Dorina Roy ◽  
Ali Ahmed
Keyword(s):  
Bladder Cancer ◽  
Closed Loop ◽  
Bladder Tumour ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Detrusor Muscle ◽  
En Bloc ◽  
Level Of Evidence ◽  
Muscle Invasive

Introduction: Our experience with the presence of detrusor muscle (DM) following Trans-Urethral Resection of Bladder Tumour (TURBT). Objectives: To evaluate the presence of DM in primary TURBT specimens as a quality improvement exercise in Frimley Park Hospital, UK. And to assess if the level of the surgeon has impact on outcomes. Methods: Retrospective and prospective analysis of the electronic records from a single urology centre, servicing a group of urologists. Data collected over three consecutive audit loops between January 2014 and May 2018. Results: A total of 301 cases were performed under the care of seven consultant urologists. Analysis revealed a significant improvement in the overall quality of resections from 39% to 66% (50–84% for intermediate and high grade) after the introduction of the following interventions: (1) analysis and improved awareness of current practice; (2) introduction of European Association of Urology (EAU) guidelines by separating samples and sending a second specimen pot marked as bladder tumour base to look for DM; (3) dedicated urologists with an interest in bladder cancer performing en-bloc resection technique in appropriate cases. Conclusion: Through our closed-loop audits, we have demonstrated a considerable improvement in the quality of resections, resulting in accurate staging from the initial resection. This could in turn lead to improved over all prognoses and negating the need for re-resection in all cases of high-risk non-muscle invasive bladder cancer (NMIBC). Level of evidence: 3

The efficacy and safety of EN BLOC resection in non-muscle-invasive bladder cancer

2020 ◽  
Vol 8 (1) ◽  
pp. 26-39
Author(s):  
E.A. Laukhtina ◽  
◽  
A.D. Shpikina ◽  
M.S. Taratkin ◽  
D.V. Enikeev ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Bladder Wall ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
En Bloc ◽  
Invasive Tumour ◽  
Operative Complications ◽  
Muscle Invasive

In surgical treatment of non-muscle-invasive bladder cancer (BC) the en bloc resection technique – removal of tumour in a single piece with the subjacent muscle (detrusor) – is becoming more widely used. The objective of this review was to assess the oncological efficacy (relapse incidence) and safety (of peri- and post-operative complications) of this technique for various tumour sizes. This systematic review was written in accordance with the PRISMA criteria. The relevant literature published over the past 20 years was chosen in two databases (Medline and Scopus) with the use of the search query “en bloc” and “bladder cancer”. We selected publications that assessed the efficacy and safety of en bloc resection of the bladder wall with non-muscle-invasive tumour, and also publications comparing the efficacy of en bloc резекции resection with that of transurethral resection (TUR) of the bladder. Based on analysis of 18 studies (1592 patients after en bloc resection), the following conclusions were made: the incidence of BC relapses after en bloc resection of the bladder wall (with non-muscle-invasive tumour) is significantly lower than after conventional TUR of the bladder; a practically 100-percent presence of muscle fibers is found in the histological tumour specimen; the frequency of peri- and post-operative complications in en bloc resection is significantly lower as compared with classical TUR; the choice of a power source does not influence the oncological outcomes, but laser en bloc resection is safer than electrical; extraction of tumours with sizes up to 2-3 cm is possible in one piece; tumours of larger diameters should be preliminary fragmented in the bladder cavity; comparison of tumours of various diameters did not reveal any statistical differences between the oncological outcomes of patients. The technique of en bloc resection of the bladder wall with non-muscle-invasive tumour is effective and safe for removal of smaller tumours (~ to 2 cm); as some authors point out, it is also effective in larger tumours but there are no literature evidence sufficient for such an. Key words: systematic review, en bloc resection, non-muscle-invasive bladder cancer

Current evidence for transurethral en bloc resection of non-muscle-invasive bladder cancer

2014 ◽  
Vol 23 (4) ◽  
pp. 206-213 ◽  
Author(s):  
Mario W. Kramer ◽  
Islam F. Abdelkawi ◽  
Mathias Wolters ◽  
Thorsten Bach ◽  
Andreas J. Gross ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Invasive Bladder Cancer ◽  
Current Evidence ◽  
Muscle Invasive Bladder Cancer ◽  
En Bloc ◽  
Muscle Invasive

scholarly journals V12-03 SAFETY AND SHORT-TERM ONCOLOGICAL OUTCOMES OF THULIUM FIBER LASER EN-BLOC RESECTION OF NON-MUSCLE-INVASIVE BLADDER CANCER

2020 ◽  
Vol 203 ◽  
pp. e1110-e1111
Author(s):  
Dmitry Enikeev* ◽  
Mark Taratkin ◽  
Ekaterina Laukhtina ◽  
Roman Sukhanov ◽  
Alim Dymov ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Fiber Laser ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Short Term ◽  
Muscle Invasive Bladder Cancer ◽  
En Bloc ◽  
Oncological Outcomes ◽  
Thulium Fiber Laser ◽  
Muscle Invasive

scholarly journals 1470 nm/980 nm dual-wavelength laser is safe and efficient for the en-bloc resection of non-muscle invasive bladder cancer: A propensity score-matched analysis

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110653
Author(s):  
Jianhan Fu ◽  
Fajun Fu ◽  
Yinhuai Wang
Keyword(s):  
Bladder Cancer ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Dual Wavelength ◽  
Muscle Invasive Bladder Cancer ◽  
En Bloc ◽  
Dual Wavelength Laser ◽  
Significant Difference ◽  
Laser Group ◽  
Muscle Invasive

Objective To evaluate the efficacy and safety of a 1470 nm/980 nm dual-wavelength laser system used for the en-bloc resection of non-muscle invasive bladder cancer (NMIBC) compared with transurethral resection of bladder tumour (TURBT). Methods This retrospective study analysed the demographic and clinical data from patients diagnosed with NMIBC that were treated by either dual laser or TURBT. Intraoperative characteristics, postoperative characteristics and outcomes between the two groups were compared. Results This study analysed 64 patients, 32 in each group. No severe complications were identified in either group. After propensity score-matching, there were no significant differences between the two groups in terms of the demographics, clinical and tumour characteristics. There was no significant difference between the two groups in terms of specimen quality. In the laser group, intraoperative blood loss was significantly lower and significantly fewer patients required continuous bladder irrigation after surgery, compared with the TURBT group. No significant differences were observed in the catheterization time, gross haematuria time and hospitalization time. Operation time in the laser group was significantly longer compared with the TURBT group. No significant difference was found in the recurrence and progression rates between the two groups. Conclusions The 1470 nm/980 nm dual-wavelength laser provides a safe and effective surgical treatment option for patients with NMIBC.

scholarly journals TECHNICAL ASPECTS OF LASER EN BLOC RESECTION OF THE BLADDER TUMOR FOR NON-MUSCLE-INVASIVE BLADDER CANCER

2020 ◽  
pp. 53-58
Author(s):  
A. A. Kamalov ◽  
N. I. Sorokin ◽  
A. M. Dymov ◽  
D. A. Kislyakov ◽  
D. M. Kamalov ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Bladder Tumor ◽  
Bladder Wall ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
En Bloc ◽  
Scientific Publications ◽  
Muscle Invasive

Abstract: In recent decades bladder cancer has become one of the most topical problems of modern healthcare due to its widespread distribution. This makes it necessary to investigate new effective methods of surgical treatment.Objective: Assessment of the effectiveness of en bloc resection of the bladder with tumor by analyzing scientific publications on this matter.Materials and methods: We have analyzed current articles related to this topic on the databases Pubmed and Google Scholar. The search was performed using the keywords «Bladder Tumor», «En bloc resection of the bladder wall», «non-muscle-invasive bladder cancer».Results: Most studies confirm the advantages of laser en bloc resection over other methods in terms of such parameters as the frequency of recurrence, macrohematuria, and the quality of morphological material.Conclusions: Laser en bloc resection of a bladder tumor without invasion of the muscle layer is a safe and effective operation that has a number of advantages over classical transurethral resection, namely: no obturator syndrome, high-quality material for pathomorphological research, low recurrence rate.

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