scholarly journals A Comparative Study on the Therapeutic Effect of en Bloc Transurethral Resection of Bladder Tumors with Needle Electrode and Traditional Transurethral Resection of Bladder Tumor on Non-Muscle Invasive Bladder Tumor

2020 ◽  
Author(s):  
Jiashuo Li ◽  
Panfeng Shang ◽  
Yidi He ◽  
Yichao Shang ◽  
Xu Zheng
Keyword(s):  
Recurrence Rate ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Control Group ◽  
Bladder Tumors ◽  
En Bloc ◽  
Factors Affecting ◽  
Surgical Safety ◽  
Kaplan Meier ◽  
Muscle Invasive

Abstract Background: En bloc transurethral resection of bladder tumors (ERBT) as an improved method of traditional transurethral resection of bladder tumor (TURBT), has not been standardized. The purpose of this study is to evaluate the safety and effectiveness of the technology.Methods: We divide non-muscle invasive bladder cancer into an experimental group receiving ERBT and a control group receiving traditional TURBT, and compared the recurrence rate by Kaplan-Meier curve adjusted by propensity score matching (PSM) analysis. In addition, we analyzed the independent risk factors affecting the recurrence rate of NMBIC by COX risk regression.Discussion: Compared with traditional transurethral resection of bladder tumor treatment, En bloc transurethral resection of bladder tumors has less intraoperative bleeding and high surgical safety. Moreover, this technique can obtain high-quality pathological specimens, which has obvious advantages in postoperative pathological assessment.

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 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.

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 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.

Single Instillation of Hypertonic Saline Immediately Following Transurethral Resection of Bladder Tumor for Recurrence Prevention –A Phase I Study

2021 ◽  
pp. 1-6
Author(s):  
Jonathan Modai ◽  
Alexey Kovalyonok ◽  
Avigdor Scherz ◽  
Dina Preise ◽  
Yuval Avda ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hypertonic Saline ◽  
Serum Sodium ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Osmotic Dehydration ◽  
Control Group ◽  
Plasma Sodium ◽  
Pelvic Cavity ◽  
Blue Discoloration

BACKGROUND: Urologic guidelines recommend perioperative instillation of chemotherapy after transurethral resection of bladder tumor (TURBT) to decrease tumor recurrence, yet implementation of this recommendation is partial due to associated morbidity. Hypertonic saline destroys cells by osmotic dehydration and might present a safer alternative. OBJECTIVE: To evaluate the safety of 3% hypertonic saline (Hypersal) intravesical instillation following TURBT in rats and in humans. METHODS: In 8 rats whose bladders were electrically injured, intravesical blue-dyed Hypersal was administered. We measured serum sodium levels before and after instillation and pathologically evaluated their pelvic cavity for signs of inflammation or blue discoloration. Twenty-four patients were recruited to the human trial (NIH-NCT04147182), 15 comprised the interventional and 10 the control group (one patient crossed over). Hypersal was given postoperatively. Serum sodium was measured before, 1 hour and 12–24 hours after instillation. Adverse effects were documented and compared between the groups. RESULTS: In rats, average sodium levels were 140.0 mEq/L and 140.3 mEq/L before and following instillation, respectively. Necropsy revealed no signs of inflammation or blue discoloration. In humans the average plasma sodium levels were 138.6 mEq∖L, 138.8 mEq∖L and 137.7 mEq∖L before, 1 hour and 12–24 hours after instillation, respectively. During the postoperative follow-up there was one case of fever. A month after the surgery, dysuria was reported by 5 patients while urgency and hematuria were reported by one patient each. The most severe adverse events were grade 2 on the Clavien-Dindo scale. Adverse events were similar in the control group. CONCLUSIONS: Hypersal instillation is safe and tolerable immediately after TURBT.

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