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)

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.

Two-step transurethral resection of bladder tumor can result in a better surgical quality and lower recurrence in patients with non-muscle invasive bladder cancer: a retrospective study

2020 ◽  
Author(s):  
Wei-Lun Huang ◽  
Chao-Yuan Huang ◽  
Kuo-How Huang ◽  
Yeong-Shiau Pu ◽  
Hong-Chiang Chang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Sampling Rate ◽  
Invasive Bladder Cancer ◽  
Detrusor Muscle ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Muscle Invasive

Abstract Background Current protocols for transurethral resection of bladder tumor (TURBT) are still unstandardized, and outcomes are also uneven in different protocols. In our medical center, we performed two-step TURBT that the resection of bladder tumor is made in two steps- exophytic parts first and tumor bases second. The purpose is to improve tumor eradication and increase detrusor muscle sampling rates. The aim of current study is to evaluate clinical outcomes and detrusor muscle sampling rate of two-step TURBT in patients with non-muscle invasive bladder cancer (NMIBC). Methods We conducted a retrospective review from a prospective database. From January 2012 to December 2017, patients who had newly diagnosed NMIBC with a follow-up period of more than 2 years were enrolled. Patients with concomitant or subsequent upper urinary tract urothelial carcinoma (UTUC) were excluded. Patients were categorized into the two-step TURBT (TR) and the conventional TURBT (CR) groups. The primary endpoints were recurrence and progression rates. The secondary endpoints were recurrence-free survival (RFS), progression-free survival (PFS), and the detrusor muscle sampling rate. Results There were 205 patients included in our study, 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 ( P = 0.015), higher detrusor muscle sampling rate ( P = 0.043), and better RFS (Log-Rank P= 0.007) in the TR group. Two-step TURBT was also associated with better RFS in both univariate ( P =0.009) and multivariate ( P =0.003) Cox proportional hazards regression. Conclusions In patients with NMIBC, Two-step TURBT results in higher detrusor muscle sampling rate and better disease outcomes. The findings suggest that Two-step TURBT is a better surgical method for treating NMIBC.

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

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.

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

scholarly journals Efficacy of the Treatment of Intraperitoneal Bladder Perforation during Transurethral Resection of Bladder Tumor with the Urethral Catheter Alone: Retrospective Analysis of over 15 Years Using the Clinical Data Warehouse System

2021 ◽  
pp. 1-9
Author(s):  
Junghoon Lee ◽  
Jungyo Suh ◽  
Chang Wook Jeong ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
...  
Keyword(s):  
Data Warehouse ◽  
Bladder Tumor ◽  
Matched Control ◽  
Foley Catheter ◽  
Progression Free Survival ◽  
Urethral Catheter ◽  
Recurrence Free Survival ◽  
Pelvic Radiotherapy ◽  
Free Survival ◽  
Clinical Data Warehouse

<b><i>Introduction:</i></b> We investigated the efficacy of a urethral catheter alone for intraperitoneal perforation during transurethral resection of bladder tumor (TURBT). <b><i>Patients and Methods:</i></b> We retrospectively evaluated the medical records of 4,543 patients who underwent TURBT from January 2000 to December 2017 using the Clinical Data Warehouse system. The clinicopathologic characteristics, recurrence-free survival, and progression-free survival were compared between the patient groups with intraperitoneal perforation treated with the Foley catheter alone, extraperitoneal perforation, and matched control TURBT. <b><i>Results:</i></b> Intraperitoneal perforation and extraperitoneal perforation were observed in 16 (35.6%) and 29 (64.4%) patients, respectively. In the intraperitoneal perforation group, 11 (68.8%), 2 (12.5%), and 3 (18.8%) patients were treated with the Foley catheter alone, additional percutaneous drainage, and delayed open surgery, respectively. The use of the Foley catheter alone in patients with intraperitoneal perforation of smaller size than the cystoscope or no pelvic radiotherapy history showed improved efficacy without sequelae or therapeutic delay. One of the 2 patients with the size of the intraperitoneal perforation larger than the cystoscope was successfully treated with the Foley catheter alone, whereas the other patient underwent delayed surgical repair. There was no difference in recurrence-free survival and progression-free survival of the intraperitoneal perforation treated with the Foley catheter alone compared to those of the matched control TURBT (<i>p</i> = 0.909, <i>p</i> = 0.518) and the extraperitoneal perforation (<i>p</i> = 0.458, <i>p</i> = 0.699). <b><i>Conclusions:</i></b> Intraperitoneal perforation rarely occurred during TURBT. In the case of intraperitoneal perforation of size smaller than cystoscopy or without pelvic radiotherapy history, treatment with the Foley alone showed successful improvement and safe oncological results. Therefore, treatment with the urethral catheter alone can be carefully considered when an intraperitoneal perforation smaller than the cystoscope size or without pelvic radiotherapy history occurs.

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