Mario W Kramer1, Vincenzo Altieri2, Rodolfo Hurle3, Lukas Lusuardi4, Axel S Merseburger1, Jens Rassweiler5, Julian P Struck1, Thomas R W Herrmann6. 1. Department of Urology, University Clinic of Schleswig-Holstein - Campus Luebeck, Luebeck, Germany. 2. Department of Urology, University Hospital of Salerno, Salerno, Italy. 3. Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano, Milan, Italy. 4. Department of Urology, General Hospital Bressanone, Bressone, Italy. 5. Department of Urology, SLK Kliniken Heilbronn, Heilbronn, Germany. 6. Department of Urology, Hanover Medical School, Hanover, Germany. Electronic address: herrmann.thomas@mh-hannover.de.
Abstract
CONTEXT: En-bloc resection of bladder tumors (ERBT) is a promising alternative to conventional transurethral resection of bladder tumor. OBJECTIVE: To review the current results of ERBT. EVIDENCE ACQUISITION: A literature search of articles that included the keywords bladder and en bloc was performed on July 15, 2016 using PubMed/Medline. Relevant English-written original articles were considered. Data from the manuscripts were categorized focusing on recent trends on resection techniques, specimens' quality, morbidity, and recurrence. EVIDENCE SYNTHESIS: ERBT provides high rates of detrusor muscle (> 95%) and specimens of high quality for pathological evaluation. It has not been analyzed whether second resections can therefore be avoided. All energy devices (lasers, electric cautery) have been used to perform ERBT with similar perioperative and oncological results. Data show that there is not much difference in respect of perioperative morbidity compared with conventional transurethral resection of bladder tumor; however, only a few publications used a systematic classification system. No conclusions can be drawn regarding the impact of ERBT on recurrence. CONCLUSIONS: The major advantage of ERBT is the high rate of detrusor muscle. Based on limited data, no significant differences are observed regarding perioperative morbidity and recurrence rates. PATIENT SUMMARY: En-bloc resection of bladder tumor is an emerging technique aimed at improving quality of surgical specimens. Available evidences suggest safety and oncologic equivalence compared with the standard transurethral resection of bladder tumor.
CONTEXT: En-bloc resection of bladder tumors (ERBT) is a promising alternative to conventional transurethral resection of bladder tumor. OBJECTIVE: To review the current results of ERBT. EVIDENCE ACQUISITION: A literature search of articles that included the keywords bladder and en bloc was performed on July 15, 2016 using PubMed/Medline. Relevant English-written original articles were considered. Data from the manuscripts were categorized focusing on recent trends on resection techniques, specimens' quality, morbidity, and recurrence. EVIDENCE SYNTHESIS: ERBT provides high rates of detrusor muscle (> 95%) and specimens of high quality for pathological evaluation. It has not been analyzed whether second resections can therefore be avoided. All energy devices (lasers, electric cautery) have been used to perform ERBT with similar perioperative and oncological results. Data show that there is not much difference in respect of perioperative morbidity compared with conventional transurethral resection of bladder tumor; however, only a few publications used a systematic classification system. No conclusions can be drawn regarding the impact of ERBT on recurrence. CONCLUSIONS: The major advantage of ERBT is the high rate of detrusor muscle. Based on limited data, no significant differences are observed regarding perioperative morbidity and recurrence rates. PATIENT SUMMARY: En-bloc resection of bladder tumor is an emerging technique aimed at improving quality of surgical specimens. Available evidences suggest safety and oncologic equivalence compared with the standard transurethral resection of bladder tumor.
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