Angelo Naselli1, Paolo Puppo2. 1. 1 Department of Urology, Ospedale San Giuseppe, Gruppo Multimedica , Milan, Italy . 2. 2 Department of Urology, Istituti Clinici di Pavia e Vigevano - Gruppo San Donato , Pavia, Italy .
Abstract
OBJECTIVE: To assess safety and efficacy, namely pathological assessment of the specimen and recurrence rate, of en bloc transurethral resection (EBTUR) of bladder tumor. MATERIALS AND METHODS: We performed a systematic review of the available literature on PubMed. Seventeen articles, mainly prospective case series, were found. EBTUR is performed with a great variety of equipments, whereas the resection technique is similar. RESULTS: Overall, 895 patients have been submitted to EBTUR, accounting for 1191 lesions. Forty complications (4%) were computed. Only 10 (1%) were grade III, mostly bladder perforation or bleeding. Fifty-nine conversions (6.5%) to conventional transurethral resection (TUR) have been reported because of difficult locations of tumors or failure to extract the specimen. Several series, accounting for 763 patients, report about incidence of detrusor muscle in the specimen. Overall, 731 (96%) cases with detrusor muscle were computed. Tumor stage remained uncertain only in 12 (1.5%) cases. Follow-up data were available for 544 patients. Mean follow-up ranged from 9.3 to 40 months. Recurrence rate varied from 6% to 55%. Most of the recurrence occurred outside primary tumor site. Mean weighted follow-up across all series was 20 months, whereas overall recurrence rate was 23%. CONCLUSIONS: Irrespective of the technique adopted, EBTUR is a safe procedure. The presence of detrusor muscle in the specimen is high if compared with historical series of conventional TUR. Indeed, recurrence rate is comparable. The objective advantage of a proper histological assessment suggests to perform EBTUR instead of conventional TUR, when feasible.
OBJECTIVE: To assess safety and efficacy, namely pathological assessment of the specimen and recurrence rate, of en bloc transurethral resection (EBTUR) of bladder tumor. MATERIALS AND METHODS: We performed a systematic review of the available literature on PubMed. Seventeen articles, mainly prospective case series, were found. EBTUR is performed with a great variety of equipments, whereas the resection technique is similar. RESULTS: Overall, 895 patients have been submitted to EBTUR, accounting for 1191 lesions. Forty complications (4%) were computed. Only 10 (1%) were grade III, mostly bladder perforation or bleeding. Fifty-nine conversions (6.5%) to conventional transurethral resection (TUR) have been reported because of difficult locations of tumors or failure to extract the specimen. Several series, accounting for 763 patients, report about incidence of detrusor muscle in the specimen. Overall, 731 (96%) cases with detrusor muscle were computed. Tumor stage remained uncertain only in 12 (1.5%) cases. Follow-up data were available for 544 patients. Mean follow-up ranged from 9.3 to 40 months. Recurrence rate varied from 6% to 55%. Most of the recurrence occurred outside primary tumor site. Mean weighted follow-up across all series was 20 months, whereas overall recurrence rate was 23%. CONCLUSIONS: Irrespective of the technique adopted, EBTUR is a safe procedure. The presence of detrusor muscle in the specimen is high if compared with historical series of conventional TUR. Indeed, recurrence rate is comparable. The objective advantage of a proper histological assessment suggests to perform EBTUR instead of conventional TUR, when feasible.
Authors: Rodolfo Hurle; Paolo Casale; Massimo Lazzeri; Marco Paciotti; Alberto Saita; Piergiuseppe Colombo; Emanuela Morenghi; David Oswald; Daniela Colleselli; Michael Mitterberger; Thomas Kunit; Martina Hager; Thomas R W Herrmann; Lukas Lusuardi Journal: World J Urol Date: 2019-05-21 Impact factor: 4.226
Authors: Sławomir Poletajew; Wojciech Krajewski; Paweł Stelmach; Jan Adamowicz; Łukasz Nowak; Marco Moschini; Piotr Zapała; Tomasz Drewa; Andrzej Paradysz; Piotr Radziszewski; Romuald Zdrojowy; Piotr Kryst Journal: Wideochir Inne Tech Maloinwazyjne Date: 2020-05-15 Impact factor: 1.195