D Oswald1, P Pallauf2, S Deininger2, T R W Herrmann3, C Netsch4, B Becker4, M Fiedler5, A Haecker6, R Homberg7, J T Klein8, K Lehrich9, A Miernik10, P Olbert11, D S Schöb10, K D Sievert12, A J Gross4, J Westphal13, L Lusuardi2. 1. Universitätsklink für Urologie und Andrologie, Paracelsus Medizinische Universität Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Österreich. d.oswald@salk.at. 2. Universitätsklink für Urologie und Andrologie, Paracelsus Medizinische Universität Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Österreich. 3. Urologie, Kantonsspital Frauenfeld, Frauenfeld, Schweiz. 4. Abteilung für Urologie, Asklepios Klinik Barmbek, Hamburg, Deutschland. 5. Klinik für Urologie, SLK-Kliniken Heilbronn GmbH, Heilbronn, Deutschland. 6. Klinik für Urologie und Kinderurologie, Gesundheitsverbund Landkreis Konstanz, Klinikum Konstanz, Konstanz, Deutschland. 7. Klinik für Urologie, Kinderurologie und Uro-Gynäkologie, St. Barbara-Klinik Hamm-Heessen, Hamm, Deutschland. 8. Urologische Klinik am Lerchenberg, Heilbronn, Deutschland. 9. Klinik für Urologie, Vivantes Auguste-Viktoria-Klinikum, Berlin, Deutschland. 10. Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Freiburg, Deutschland. 11. BRIXSANA private clinic, Brixen, Italien. 12. UKOWL, Campus Klinikum Lippe, Detmold, Deutschland. 13. Klinik für Urologie, Kinderurologie und Urogynäkologie, Krankenhaus Maria Hilf der Alexianer GmbH, Krefeld, Deutschland.
Abstract
BACKGROUND: En bloc tumor resection of bladder tumors (ERBT) is a novel alternative procedure to conventional resection of bladder tumor (cTURBT), which might help to address common problems of the standard method, such as inadequate detrusor muscle in specimens, high re-resection rates and high recurrence rates. OBJECTIVE: To analyze current data on ERBT in efficacy and safety compared to cTURBT. DATA SOURCES: PubMed. STUDY SELECTION: Two independent authors identified trials based on keywords and inclusion criteria. A third author was consulted in case of discrepancies. Screening keywords: ERBT, en bloc transurethral resection of bladder tumor, TURBT en bloc. A meta-analysis of 13 studies was performed. The effect size was estimated based on odds ratios and mean differences including their corresponding two-sided 95% confidence intervals. DATA SYNTHESIS: The analyzed studies comprised a homogenous collective in terms of tumor size, tumor multiplicity and tumor stage. Operation time did not significantly differ between the methods. Differences were observed in hospitalization and catheterization time in favor of ERBT. Reported complications did not show clear differences. There was significantly more detrusor muscle in the specimens in the ERBT group. No significant differences were found in recurrence up to 2 years of follow-up. CONCLUSION: ERBT is a safe alternative to conventional TURBT with promising features regarding effective resection of detrusor muscle. More standardized data on recurrence rates, different resection modalities and resection margin results are needed.
BACKGROUND: En bloc tumor resection of bladder tumors (ERBT) is a novel alternative procedure to conventional resection of bladder tumor (cTURBT), which might help to address common problems of the standard method, such as inadequate detrusor muscle in specimens, high re-resection rates and high recurrence rates. OBJECTIVE: To analyze current data on ERBT in efficacy and safety compared to cTURBT. DATA SOURCES: PubMed. STUDY SELECTION: Two independent authors identified trials based on keywords and inclusion criteria. A third author was consulted in case of discrepancies. Screening keywords: ERBT, en bloc transurethral resection of bladder tumor, TURBT en bloc. A meta-analysis of 13 studies was performed. The effect size was estimated based on odds ratios and mean differences including their corresponding two-sided 95% confidence intervals. DATA SYNTHESIS: The analyzed studies comprised a homogenous collective in terms of tumor size, tumor multiplicity and tumor stage. Operation time did not significantly differ between the methods. Differences were observed in hospitalization and catheterization time in favor of ERBT. Reported complications did not show clear differences. There was significantly more detrusor muscle in the specimens in the ERBT group. No significant differences were found in recurrence up to 2 years of follow-up. CONCLUSION: ERBT is a safe alternative to conventional TURBT with promising features regarding effective resection of detrusor muscle. More standardized data on recurrence rates, different resection modalities and resection margin results are needed.
Authors: Amr Mahran; Laura Bukavina; Kirtishri Mishra; Christina Buzzy; Morgan L Fish; Aidan Bobrow; Lee Ponsky Journal: Can J Urol Date: 2018-12 Impact factor: 1.344
Authors: Liselotte Boevé; Maarten C C M Hulshof; Paul C M S Verhagen; Jos W R Twisk; Wim P J Witjes; Peter de Vries; R Jeroen A van Moorselaar; George van Andel; André N Vis Journal: Eur Urol Date: 2020-09-22 Impact factor: 20.096