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 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 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.

EN BLOC RESECTION OF BLADDER TUMOR(EBRT) USING MONOPOLAR CAUTERY; A TERTIARY HOSPITAL EXPERIENCE.

2021 ◽  
pp. 15-16
Author(s):  
Neeraj Agarwal ◽  
Bhuwan kumar ◽  
Prashant Gupta ◽  
Govind Sharma ◽  
Shivam Priyadarshi
Keyword(s):  
Bladder Cancer ◽  
Correct Diagnosis ◽  
En Bloc Resection ◽  
Tertiary Hospital ◽  
Complete Resection ◽  
High Rate ◽  
Severe Bleeding ◽  
Detrusor Muscle ◽  
Bladder Tumors ◽  
En Bloc

Bladder cancer is a growing health problem with the second most common urological malignancy. It accounts for around 7% of a new cancer diagnosis. Tobacco smoking is the most important risk factor accounting for around 50% of cases. Tobacco smokes contain aromatic amines and polycyclic hydrocarbons which are excreted through kidneys. The goal of transurethral biopsy in NMIBC(non-muscle invasive bladder cancer) is to make the correct diagnosis and completely remove all visible lesions which can be either resected piecemeal or en bloc. The presence of detrusor muscle in the specimen is an important factor for planning treatment and prognosis. Here we share our experience of EBRT using monopolar cautery describing the feasibility, safety, and adequacy of the procedure in the management of small urinary bladder tumors. The study was conducted in the Department of Urology, SMS Medical College, and attached hospitals. All the patients with clinical NMIBC during study duration were admitted and a total of 25 patients above the age of 18yrs, having papillary bladder tumors less than 3 cm were included in the study. Complete resection by the en bloc technique was achieved in all 25 cases with no requirement of conversion to conventional TURBT. Our study also shows the presence of detrusor muscle in 22 specimens out of 25. And only two patients developed severe bleeding which needed a blood transfusion. Thus, ERBT using monopolar cautery is safe and feasible for the complete resection of NMIBCs with a high rate of detrusor-positive specimens in the selected patient population.

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.

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

Sign in / Sign up

Export Citation Format

Share Document