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

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.

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

10.21203/rs.2.11157/v1 ◽

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

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Safety and efficacy of bipolar versus monopolar transurethral resection of bladder tumor: a systematic review and meta-analysis

World Journal of Urology ◽

10.1007/s00345-020-03248-2 ◽

2020 ◽

Cited By ~ 1

Author(s):

Zhongbao Zhou ◽

Zhenli Gao ◽

Jitao Wu ◽

Yuanshan Cui

Keyword(s):

Systematic Review ◽

Transurethral Resection ◽

Bladder Tumor ◽

Meta Analysis ◽

Safety And Efficacy

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Safety and Efficacy of Transurethral Resection of Bladder Tumor Comparing Spinal Anesthesia with Spinal Anesthesia with an Obturator Nerve Block: A Systematic Review and Meta-analysis

Journal of Endourology ◽

10.1089/end.2020.1054 ◽

2020 ◽

Author(s):

Anil Krishan ◽

Angus Bruce ◽

Shehab Khashaba ◽

Mohamed Abouelela ◽

Syed Ali Ehsanullah

Keyword(s):

Systematic Review ◽

Spinal Anesthesia ◽

Nerve Block ◽

Transurethral Resection ◽

Bladder Tumor ◽

Meta Analysis ◽

Obturator Nerve ◽

Safety And Efficacy ◽

Obturator Nerve Block

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

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.09.11363 ◽

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)

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Comparison of the Safety and efficacy of enucleation of nonmuscle-invasive bladder cancer versus transurethral resection of nonmuscle-invasive bladder cancer: a systematic review and meta-analysis

10.21203/rs.2.14352/v1 ◽

2019 ◽

Author(s):

Ting Huang ◽

Haixiao Wu ◽

Qing Yang ◽

Han Wu ◽

Heng Zhang

Keyword(s):

Systematic Review ◽

Bladder Cancer ◽

Transurethral Resection ◽

Bladder Tumor ◽

Meta Analysis ◽

En Bloc Resection ◽

Invasive Bladder Cancer ◽

Controlled Trials ◽

En Bloc ◽

Nonmuscle Invasive Bladder Cancer

Abstract Purpose: Transurethral resection of bladder tumor (TURBT) via a wire loop has been regarded as a standard procedure dealing with nonmuscle-invasive bladder cancer (NMIBC) for a long time, and en-bloc resection of bladder tumors (ERBT) is a promising alternative to conventional transurethral resection of bladder tumor. A few studys assessing the two techniques were reported. The objective of our study is to review the published literature and compare en-bloc resection for non–muscle-invasive bladder cancer (NMIBC) with conventional transurethral resection of bladder tumor (TURBT) in terms of safety and efficacy. Methods: We performed a systematic review and meta-analysis based on randomized controlled trials (RCTs) and non-randomized controlled trials(nRCTs) and some retrospective studys which were searched and sreened. A systematic search up to the 1st of March 2019 was conducted in the following databases: PubMed, Web of Science,the Cochrane Central Register of Controlled Trials and Embase. Data such as resection techniques, morbidity, specimens’ quality, and recurrence were collected from the manuscripts.Results: Sixteen studies were included in this systematic review finnally.No statistical difference is detectded between the two techniques regarding operative time,the 2-year recurrence-free survival and the occurrence of ureterostenosis.Analysis of some complications showed that ERBT was better than TURBT for NMIBC, including obturator nerve reflex, cystic stimulation rate, bladder perforation, operation time,duration of catheterization, postoperation duration of postoperation bladder irritation and length of hospital stay. In addition, detrusor miss rate is lower in ERBT group,the 1-year and 3-year recurrence-free survival improved in the ERBT group than in the TURBT group. Conclusions: This systematic review and meta-analysis suggests that ERBT technique is a feasible, safe procedures that may provide an alternative treatment for NMIBC.

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The eﬃcacy and safety of thulium laser resection of bladder tumor versus standard transurethral resection in patients with non muscle-invasive bladder cancer: a systematic review and meta-analysis

10.31083/jomh.2021.023 ◽

2021 ◽

Keyword(s):

Bladder Cancer ◽

Recurrence Rate ◽

Bladder Tumor ◽

Meta Analysis ◽

Efficacy And Safety ◽

Thulium Laser ◽

Muscle Invasive Bladder Cancer ◽

Laser Resection ◽

Significant Difference ◽

Muscle Invasive

Purpose: This study was to analyze the eﬃcacy and safety of thulium laser resection of bladder tumor (Tm-TURBT) versus TURBT for patients with non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: Randomized controlled trial data were retrieved using the MEDLINE, Embase, Web of Science, and the Cochrane Library. We also searched Chinese databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang data and VIP data. Results: A total of sixteen articles including 1662 participants were enrolled into our meta-analysis. We found no signiﬁcant difference in terms of operation time, urethral stricture, 1-year recurrence rate, overall 1-year recurrence rate and overall 3-year recurrence rate between the two groups. Less intraoperative blood loss and a lower incidence of obturator nerve reﬂex (ONR), bladder perforation and bladder irritation were identiﬁed in Tm-TURBT group than in TURBT group in our analysis. The analysis also demonstrated faster postoperative recovery in terms of the catheterization, bladder irrigation and hospitalization time in Tm-TURBT group. The subgroup analysis was conducted based on different postoperative chemotherapy (epirubicin and non-epirubicin) concerning recurrence rate whereas no signiﬁcant difference was noted. Conclusion: Tm-TURBT is an eﬃcient and safe treatment for NMIBC and it could be an alternative choice for TURBT. Given that some limitations are clearly identiﬁed, more large-scale and well-designed RCTs are needed to conﬁrm our ﬁndings.

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Does En-bloc transurethral resection of bladder tumor give a better yield in terms of presence of detrusor muscle in the biopsy specimen?

Indian Journal of Urology ◽

10.4103/0970-1591.102700 ◽

2012 ◽

Vol 28 (3) ◽

pp. 275 ◽

Cited By ~ 3

Author(s):

Anil Mandhani ◽

Rohit Upadhyay ◽

Rakesh Kapoor ◽

Amish Srivastava ◽

Narendra Krishnani

Keyword(s):

Transurethral Resection ◽

Biopsy Specimen ◽

Bladder Tumor ◽

Detrusor Muscle ◽

En Bloc

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Two-step transurethral resection of bladder tumor improves surgical quality and decreases disease recurrence: a retrospective study

10.21203/rs.2.17859/v1 ◽

2019 ◽

Author(s):

Wei-Lun Huang ◽

Chao-Yuan Huang ◽

Kuo-How Huang ◽

Yeong-Shiau Pu ◽

Hong-Chiang Chang ◽

...

Keyword(s):

Recurrence Rate ◽

Transurethral Resection ◽

Bladder Tumor ◽

Sampling Rate ◽

Progression Free Survival ◽

Progression Rate ◽

Detrusor Muscle ◽

Free Survival ◽

Lower Recurrence Rate

Abstract Background: Two-step transurethral resection of bladder tumor (TURBT) is a method of TURBT that is performed in two steps- exophytic tumors first and tumor bases second. The purpose is to improve tumor clearance. In current study, we evaluated outcomes of two-step TURBT in patients with non-muscle invasive bladder cancer (NMIBC). Methods: We retrospectively reviewed a prospective database. Patients who had newly diagnosed NMIBC with at least a 2-year follow-up period during Jan. 1, 2012 and Dec. 31, 2017 were enrolled. Patients with concomitant or subsequent upper urinary tract urothelial carcinoma (UTUC) were excluded. Patients were categorized into the two-step TURBT (TR) group and the conventional TURBT (CR) group. The primary endpoints were the recurrence rate and the progression rate. The secondary endpoints were the recurrence-free survival (RFS), the progression-free survival (PFS), and the detrusor muscle sampling rate. Results: A total of 205 patients were included, with 151 patients in the TR group and 54 patients in the CR group. The median follow-up period was 40.5 months. There were lower recurrence rate (29.8% vs 48.1%, P = 0.015), higher detrusor muscle sampling rate (70.7% vs 55.6%, P = 0.043), and longer RFS ( P= 0.007) in the TR group. TR was also associated with longer RFS in both univariate (HR=0.524, p =0.009) and multivariate (HR=0.426, p =0.003) analysis. Conclusions: Two-step TURBT results in lower recurrence rate and longer RFS for NMIBC, especially for Ta disease. Two-step TURBT also improves detrusor muscle sampling rate, which is essential for adequate resection and accurate staging.

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