Ahmed Adam1,2,3, Jayveer Sookram1,2,3, Amit Sattish Bhattu4, Reubina Wadee5, Marlon Perera6,7, Nathan Lawrentschuk7,8. 1. Department of Urology, Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa. 2. Department of Paediatric Urology, Rahima Moosa Mother & Child (Coronation) Hospital, University of the Witwatersrand, Johannesburg, South Africa. 3. The Division of Urology, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 4. Department of Urological Oncology, Jackson Memorial Hospital-University of Miami Health system, Miami, FL, USA. 5. Division of Anatomical Pathology, University of the Witwatersrand and the National Health Laboratory Services, Johannesburg, South Africa. 6. Royal Brisbane Hospital, University of Queensland, Brisbane, Australia. 7. Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia. 8. Department of Surgical Oncology, Peter MacCullum Hospital, Melbourne, Australia.
Abstract
BACKGROUND: To assess if trans-urethral snare of bladder tumor (TUSnBT) with subsequent stone basket retrieval can be used as an effective, time-saving adjunct resection technique for papillary bladder lesions. METHODS: Via standard cystoscopy, TUSnBT was performed using a standard endoscopic polypectomy snare with subsequent tumor extraction utilizing a standard stone retrieval basket, when lesions were more than 10 mm in diameter. Smaller lesions were removed with the polypectomy snare. Standard trans-urethral resection of bladder tumors (TURBT) of the tumor bed was performed post TUSnBT. Histological assessment was performed and assessed separately per session. RESULTS: In total, 18 papillary lesions, measuring between 9 and 26 mm, were resected via TUSnBT. Operative TUSnBT time, ranged between 10 and 60 seconds duration per lesion. No significant postoperative morbidity was experienced by patients within this cohort. Histo-pathological assessment revealed adequate muscle representation in 83.3 % of TUSnBT grouped sessions assessed. CONCLUSION: TUSnBT with stone retrieval basket retrieval is a feasible method in selected papillary bladder lesions, and may be coupled with standard TURBT resection techniques. This method is less time consuming and would prove beneficial in select lesions. It may also be beneficial to assist with reducing the resection time or inadvertent bladder perforation encountered during the conventional TURBT.
BACKGROUND: To assess if trans-urethral snare of bladder tumor (TUSnBT) with subsequent stone basket retrieval can be used as an effective, time-saving adjunct resection technique for papillary bladder lesions. METHODS: Via standard cystoscopy, TUSnBT was performed using a standard endoscopic polypectomy snare with subsequent tumor extraction utilizing a standard stone retrieval basket, when lesions were more than 10 mm in diameter. Smaller lesions were removed with the polypectomy snare. Standard trans-urethral resection of bladder tumors (TURBT) of the tumor bed was performed post TUSnBT. Histological assessment was performed and assessed separately per session. RESULTS: In total, 18 papillary lesions, measuring between 9 and 26 mm, were resected via TUSnBT. Operative TUSnBT time, ranged between 10 and 60 seconds duration per lesion. No significant postoperative morbidity was experienced by patients within this cohort. Histo-pathological assessment revealed adequate muscle representation in 83.3 % of TUSnBT grouped sessions assessed. CONCLUSION: TUSnBT with stone retrieval basket retrieval is a feasible method in selected papillary bladder lesions, and may be coupled with standard TURBT resection techniques. This method is less time consuming and would prove beneficial in select lesions. It may also be beneficial to assist with reducing the resection time or inadvertent bladder perforation encountered during the conventional TURBT.
Entities:
Keywords:
Endoscopic management; Novel time-saving technique; Papillary bladder lesions; Stone basket retrieval; Transurethral snare of bladder tumor
Authors: Kyung Jin Oh; Yoo-Duk Choi; Ho Suck Chung; Eu Chang Hwang; Seung Il Jung; Dong Deuk Kwon; Kwangsung Park; Taek Won Kang Journal: Korean J Urol Date: 2015-02-26