Endourological treatment of non-muscular-invasive bladder tumors

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.

Download Full-text

Comparative analysis between En-bloc resection and transurethral resection of non-muscular invasive bladder tumors

The Moldovan Medical Journal ◽

10.52418/moldovan-med-j.64-2.21.12 ◽

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.

Download Full-text

Randomized controlled trial comparing holmium laser en-bloc resection with monopolar transurethral resection in patients with large bladder tumors

European Urology ◽

10.1016/s0302-2838(21)01242-2 ◽

2021 ◽

Vol 79 ◽

pp. S1216

Author(s):

A. Iscaife ◽

L.A. Ribeiro Filho ◽

M.W. Aparecido Pereira ◽

F. Pescarmona Gallucci ◽

D. Chade ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Transurethral Resection ◽

Controlled Trial ◽

En Bloc Resection ◽

Bloc Resection ◽

Holmium Laser ◽

Bladder Tumors ◽

En Bloc ◽

Randomized Controlled

Download Full-text

Holmium Laser En-bloc Resection Versus Conventional Transurethral Resection of Bladder Tumors for Treatment of Non–muscle-invasive Bladder Cancer: A Randomized Clinical Trial

European Urology Focus ◽

10.1016/j.euf.2020.12.003 ◽

2020 ◽

Author(s):

Abdelwahab Hashem ◽

Ahmed Mosbah ◽

Nasr A. El-Tabey ◽

Mahmoud Laymon ◽

El-Houssieny Ibrahiem ◽

...

Keyword(s):

Clinical Trial ◽

Bladder Cancer ◽

Randomized Clinical Trial ◽

Transurethral Resection ◽

En Bloc Resection ◽

Bloc Resection ◽

Bladder Tumors ◽

Muscle Invasive Bladder Cancer ◽

En Bloc ◽

Muscle Invasive

Download Full-text

ANALYSIS OF ENDOUROLOGICAL TREATMENT TECHNIQUES OF URINARY BLADDER TUMORS

InterConf ◽

10.51582/interconf.19-20.03.2021.028 ◽

2021 ◽

pp. 290-298

Author(s):

Ivan Vladanov ◽

Alexei Plesacov ◽

Vitalii Ghicavii

Keyword(s):

Urinary Bladder ◽

Transurethral Resection ◽

Standard Technique ◽

Tumor Stage ◽

En Bloc Resection ◽

Bloc Resection ◽

Diagnosis And Treatment ◽

Bladder Tumors ◽

En Bloc ◽

Treatment Techniques

Transurethral resection is very important not only for diagnosis and treatment of NMIBC, but also for its management. The application field of transurethral resection includes establishing histological diagnosis, determination of prognostic factors including the tumor stage, complete resection of all detected tumors of urinary bladder. Transurethral resection of bladder tumor (TURBT) is the standard technique for the diagnosis and treatment of non-muscle invasive bladder cancer. This method has also some limitations. One of the limitations is the insufficient assessment of the resection depth. It leads to the necessity of intravesical tumor fragmentation, but its disadvantage is that it limits the histopathological evaluation. In order to improve the treatment outcome for patients with non-muscular invasive bladder tumors, several new techniques such as En-bloc resection were proposed.

Download Full-text

En Bloc Resection of Bladder Tumor—Is It the Way Forward?

Frontiers in Surgery ◽

10.3389/fsurg.2021.685506 ◽

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.

Download Full-text

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

10.36106/ijar/8300518 ◽

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.

Download Full-text