Transurethral en bloc resection of bladder tumors

被引:4
|
作者
Martov, A. G. [1 ]
Ergakov, D. V. [1 ]
Baykov, N. A. [1 ]
Pominalnaya, V. M. [1 ]
Solomatnikov, I. A. [1 ]
机构
[1] City Clin Hosp Fifty Seven, Moscow Healthcare Dept, Dept Urol, 32,Eleventh Parkovaya St, Moscow 105077, Russia
来源
ONKOUROLOGIYA | 2015年 / 11卷 / 01期
关键词
bladder cancer; in situ bladder cancer; noninvasive bladder cancer; transurethral resection of the bladder; holmium resection of the bladder; laser resection of the bladder; en bloc endoscopic resection of the bladder; en bloc techniques; recurrent bladder cancer; safety of method; efficiency of method;
D O I
10.17650/1726-9776-2015-1-41-49
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. The high incidence of recurrent non-muscle-invasive bladder carcinoma (BC) necessitates searches for new surgical methods. Objective: to comparatively evaluate the efficiency and safety of en block resection of bladder tumors versus transurethral resection (TUR). Subjects and methods. In January 2010 to June 2013, a total of 292 patients with primary and recurrent bladder tumor stages, cTa-T2, underwent transurethral endoscopic treatment (as TUR) at the Unit of Minimally Invasive Urology, Moscow City Clinical Hospital Fifty-Seven. A major portion of these patients were included in the study of the efficiency and safety of en bloc TUR of bladder tumors. The criteria for study inclusion were primary or recurrent non-muscle-invasive bladder tumor measuring 1 to 3 cm, stage pTa-T1, signed informed consent to participate in the study and patients-readiness to undergo control examinations in inpatient setting for one year. The exclusion criteria were a confirmed or detected muscleinvasive tumor, multiple bladder involvement (> 3 tumors), as well as detected tumors spreading to the ureter, bladder neck, and prostatic urethra. The primary study endpoint was considered to be a recurrence of a tumor after TUR of the bladder (TURB). The secondary endpoint was the frequency of concealed bladder perforation, blood transfusions, recystoscopies for bladder tamponade, early recystoscopies to specify a BC stage, and the frequency of immediate intravesical injection of a chemical. For final analysis, the investigators selected 106 patients in a group where tumors were removed en bloc (a study group) and 133 patients in a group where tumors were retrieved using traditional TURB (a control group). In the study group, the tumor was removed en bloc by a monopolar J-shaped electrode (sand wedge electrode) in 45 patients, by a hook-like electrode in 14, by a hybrid procedure (hydropreparation and monopolar electrosurgery by a water-jet hybrid knife) in 10, and by holmium laser in the remaining 37 patients. Results. The recurrence rates in the study and control groups were 10.4 and 21.8 %, respectively (p <= 0.05). There were no significant differences in the time of surgery, the periods of bladder drainage, and the frequency of complications. In the study group, the immediate instillation of a chemical was possible in 54.7 % of the patients versus 24 % in the control group (p <= 0.05), indirectly suggesting that en bloc TUR of the bladder was less safe (the bladder resection area, concealed perforations, hemorrhagic complications, etc. were less.). Early recystoscopy and biopsy were required in 9.4 % of the patients in the study group versus 24 % of those in the control group (p <= 0.05), which is mainly attributable to more qualitative histological material obtained during en bloc TUR. According to the visual analogue scale, the quality of the histological materials obtained by retrieving the tumor en block was 93 versus 61 scores during standard TUR. Conclusion. En bloc TUR of the bladder is more effective and safer than standard TUR in the group of patients with non-muscle-invasive BC and 1-3-cm tumors. Histological material obtained by removing the tumor en bloc can provide a more qualitative morphological opinion.
引用
收藏
页码:41 / 49
页数:9
相关论文
共 50 条
  • [41] EN BLOC TRANSURETHRAL RESECTION OF BLADDER LESIONS: A TRICK TO RETRIEVE SPECIMENS UP TO 4.5 CM
    Ganpule, Arvind
    BJU INTERNATIONAL, 2012, 110 (04) : E158 - E159
  • [42] Transurethral en bloc resection of a bladder perivascular epithelioid cell tumor (PEComa): a case report
    Shi-Ping Zeng
    Yi-Fei Sun
    Jun-Bing Ye
    Ke Zeng
    Xiao-Bin Li
    BMC Urology, 23
  • [43] En-bloc Laser Resection of Bladder Tumors: Where Are We Now?
    Creta, Massimiliano
    Celentano, Giuseppe
    Califano, Gianluigi
    La Rocca, Roberto
    Longo, Nicola
    JOURNAL OF CLINICAL MEDICINE, 2022, 11 (12)
  • [44] Modified transurethral resection of bladder tumors: A comparison study of chemotherapy-enhanced endoscopic submucosal en bloc dissection versus conventional resection.
    Liu, Xi
    Wang, Yiding
    Wang, Zhe
    Shao, Bo
    Liu, Qiang
    Li, Changqi
    Lv, Chengcheng
    Bi, Huan
    Shan, Guangyi
    Chen, Ang
    Zeng, Yu
    JOURNAL OF CLINICAL ONCOLOGY, 2025, 43 (5_SUPPL)
  • [45] En-bloc versus conventional transurethral resection of bladder tumors: Interim analysis of a single-center prospective randomized trial
    Fontana, M.
    Diana, P.
    Territo, A.
    Gallioli, A.
    Piana, A.
    Mercade, A.
    Fontanet, S.
    Algaba, F.
    Rodriguez-Faba, O.
    Gaya, Sopena J. M.
    Palou, J.
    Breda, A.
    EUROPEAN UROLOGY, 2021, 79 : S1047 - S1048
  • [46] Transurethral resection of bladder tumors (TURBT)
    Oswald, D.
    Pallauf, M.
    Herrmann, T. R. W.
    Netsch, C.
    Becker, B.
    Lehrich, K.
    Miernik, A.
    Schoeb, D. S.
    Sievert, K. D.
    Gross, A. J.
    Westphal, J.
    Lusuardi, L.
    Deininger, S.
    UROLOGE, 2022, 61 (01): : 71 - 82
  • [47] Holmium Laser En-bloc Resection Versus Conventional Transurethral Resection of Bladder Tumors for Treatment of Non-muscle-invasive Bladder Cancer: A Randomized Clinical Trial
    Hashem, Abdelwahab
    Mosbah, Ahmed
    El-Tabey, Nasr A.
    Laymon, Mahmoud
    Ibrahiem, El-Houssieny
    Abd Elhamid, Mohamed
    Elshal, Ahmed M.
    EUROPEAN UROLOGY FOCUS, 2021, 7 (05): : 1035 - 1043
  • [48] EN-BLOC VERSUS CONVENTIONAL TRANSURETHRAL RESECTION OF BLADDER TUMORS: INTERIM ANALYSIS OF A SINGLE-CENTER PROSPECTIVE RANDOMIZED TRIAL
    Diana, Pietro
    Fontana, Matteo
    Territo, Angelo
    Gallioli, Andrea
    Piana, Alberto
    Marcade, Asier
    Fontanet, Sofia
    Algaba, Ferran
    Rodriguez-Faba, Oscar
    Maria Gaya, Josep
    Palou, Joan
    Breda, Alberto
    JOURNAL OF UROLOGY, 2021, 206 : E121 - E121
  • [49] Transurethral resection of bladder tumors (TURBT)
    Oswald, D.
    Pallauf, M.
    Herrmann, T. R. W.
    Netsch, C.
    Becker, B.
    Lehrich, K.
    Miernik, A.
    Schoeb, D. S.
    Sievert, K. D.
    Gross, A. J.
    Westphal, J.
    Lusuardi, L.
    Deininger, S.
    UROLOGIE, 2022, 61 (01): : 71 - 79
  • [50] COMPARISON OF CLINICOPATHOLOGICAL OUTCOMES IN HOLMIUM LASER EN-BLOC RESECTION OF BLADDER TUMOR VS BIPOLAR TRANSURETHRAL RESECTION OF BLADDER TUMOUR
    Nayak, Prasant
    Ram, Prasanna
    Tarigopula, Vivek
    Das, Manoj Kumar
    Mandal, Swarnendu
    Tripathy, Sambit
    JOURNAL OF UROLOGY, 2024, 211 (05): : E1162 - E1162