1
|
Ergün O, Alperen Öztürk S, Kırçiçek F, Gürdal O, Soyupek S, Oksay T, Özorak A. Increased Plasma Ignition Distance Practice may Prevent the Obturator Reflex Occurrences and Compare of its Effectiveness Versus Obturator Block: A Prospective, Randomized, Controlled Study. Urology 2023; 176:226-231. [PMID: 36934912 DOI: 10.1016/j.urology.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/01/2023] [Accepted: 03/05/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE To compare the ability of the obturator nerve block (ONB) and increased plasma ignition distance practice (IPDP) techniques to inhibit obturator nerve reflex (ONR) occurring with bipolar transurethral resection of the bladder. METHODS Sixty patients who had a tumor placed at the lateral sidewall or had a tumor in another part of the bladder along with the lateral wall were randomly enrolled. Cystoscopic and ultrasonographic examinations and a computerized tomography scanning of the urinary bladder were used to determine the ONB side. Group 1 consisted of patients who had the ONB procedure. Group 2 consisted of patients who had IPIDP. The severity of the ONR was classified as severe, mild, and very mild. The study's primary endpoint was ONR occurrences and successful completion of the surgery. The secondary endpoints were bleeding and bladder perforation. RESULTS There was a significant difference in the occurrence of ONR between the two groups (P = 0.0011). However, there was no significant difference between the two groups in the ability to resect the tumor and complete the surgery (P = .764). There was no correlation between the ONR and the tumor size (P = 0.478). CONCLUSION Our study concluded that both ONB and IPIDP have comparable results, especially in resecting tumors and completing the operation. IPIDP has some advantages over ONB, such as shorter operative time, lower total costs, and less trained personnel requirements.
Collapse
Affiliation(s)
- Osman Ergün
- Süleyman Demirel University, Medical School, Department of Urology, Isparta, Turkey.
| | - Sefa Alperen Öztürk
- Süleyman Demirel University, Medical School, Department of Urology, Isparta, Turkey
| | - Fahrettin Kırçiçek
- Sağlık Bilimleri University, Gazi Yaşargil Training and Research Hospital, Department of Anesthesiology and Reanimation, Diyarbakır, Turkey
| | - Osman Gürdal
- Suleyman Demirel University, Medical School, Department of Biostatistics and Medical Informatics, Isparta, TURKEY
| | - Sedat Soyupek
- Süleyman Demirel University, Medical School, Department of Urology, Isparta, Turkey
| | - Taylan Oksay
- Süleyman Demirel University, Medical School, Department of Urology, Isparta, Turkey
| | - Alper Özorak
- Süleyman Demirel University, Medical School, Department of Urology, Isparta, Turkey
| |
Collapse
|
2
|
Sharma G, Sharma AP. Comment on "Safety and efficacy of bipolar versus monopolar transurethral resection of bladder tumor: a systematic review and meta-analysis". World J Urol 2021; 39:3119-3120. [PMID: 32504315 DOI: 10.1007/s00345-020-03280-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Gopal Sharma
- Department of Urology, PGIMER, Level II B Block AUC PGIMER Sector 12, Chandigarh, 160012, India
| | - Aditya Prakash Sharma
- Department of Urology, PGIMER, Level II B Block AUC PGIMER Sector 12, Chandigarh, 160012, India.
| |
Collapse
|
3
|
Lonati C, Esperto F, Scarpa RM, Papalia R, Gómez Rivas J, Alvarez-Maestro M, Afferi L, Fankhauser CD, Mattei A, Colombo R, Montorsi F, Briganti A, Krajewski W, Carando R, Laukhtina E, Teoh JY, Zamboni S, Simeone C, Moschini M. Bladder perforation during transurethral resection of the bladder: a comprehensive algorithm for diagnosis, management and follow up. Minerva Urol Nephrol 2021; 74:570-580. [PMID: 34263743 DOI: 10.23736/s2724-6051.21.04436-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Despite bladder perforation (BP) is a frequent complication during transurethral resection of bladder (TURB) for bladder cancer (BCa), literature lacks systematic reviews focusing on this issue. We aimed to investigate incidence, diagnosis, therapy, and prognosis after BP during TURB for BCa; therapy was distinguished between conservative (without the need for bladder repair) and surgical management (requiring bladder wall closure). EVIDENCE ACQUISITION A systematic search was conducted up to April 2021 using PubMed, Scopus, Cochrane Database of Systematic Reviews, and Web of Science to identify articles focusing on incidence, detection, management, or survival outcomes after iatrogenic BP. The selection of articles followed the Preferred Reporting Items for Systematic Review and Meta-Analyses process. EVIDENCE SYNTHESIS We included 41 studies, involving 21,174 patients. Overall, 521 patients experienced BP during TURB for BCa, with a mean incidence of 2.4%, up to 58.3% when post-operative cystography is routinely performed after all TURB procedures. Risk factors were low body mass index (BMI) (p=0.01), resection depth (p=0.006 and p=0.03), and low surgical experience (p=0.006). Extraperitoneal BP (68.5%) were treated conservatively in 97.5% of patients; intraperitoneal BP were managed with surgical bladder closure in 56% of cases. Overall, three immediate BP-related deaths were recorded due to septic complications. Extravesical tumour seeding was observed after 6 intraperitoneal and 1 extraperitoneal BP (median time: 6.2 months). Intraperitoneal BP (p=0.0003) and bladder closure (p<0.001) were found as independent predictors of extravesical tumour recurrence. CONCLUSIONS BP is more frequent than expected when proper diagnosis is routinely performed after all TURB procedures. Risk factors include low BMI, resection depth, and unexperienced surgeon. The risk of sepsis after BP suggests empirical antibiotic prophylaxis after BP.
Collapse
Affiliation(s)
- Chiara Lonati
- Department of Urology, Spedali Civili of Brescia, Brescia, Italy - .,Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland -
| | - Francesco Esperto
- Department of Urology, Campus Bio-Medico, University of Rome, Rome, Italy
| | - Roberto M Scarpa
- Department of Urology, Campus Bio-Medico, University of Rome, Rome, Italy
| | - Rocco Papalia
- Department of Urology, Campus Bio-Medico, University of Rome, Rome, Italy
| | - Juan Gómez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain
| | | | - Luca Afferi
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | | | - Agostino Mattei
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Renzo Colombo
- Department of Urology, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Montorsi
- Department of Urology, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Briganti
- Department of Urology, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Wojciech Krajewski
- Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland
| | - Roberto Carando
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland.,Clinica Luganese Moncucco, Lugano, Switzerland.,Clinica S.Anna, Swiss Medical Group, Sorengo, Switzerland.,Clinica Santa Chiara, Locarno, Switzerland
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Jeremy Y Teoh
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Stefania Zamboni
- Department of Urology, Spedali Civili of Brescia, Brescia, Italy
| | - Claudio Simeone
- Department of Urology, Spedali Civili of Brescia, Brescia, Italy
| | - Marco Moschini
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland.,Department of Urology, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | | | | |
Collapse
|
4
|
Mao X, Zhou Z, Cui Y, Zhang Y, Yang M. Outcomes and Complications of Bipolar vs. Monopolar Energy for Transurethral Resection of Bladder Tumors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Surg 2021; 8:583806. [PMID: 34150834 PMCID: PMC8206278 DOI: 10.3389/fsurg.2021.583806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 04/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Bipolar and monopolar transurethral resections have a stable status for non-muscle invasive bladder cancer (NMIBC). We conducted a meta-analysis to analyze the outcomes and complications of bipolar vs. monopolar energy for transurethral resection of bladder tumors (TURB). Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses was followed. Based on the Population, Intervention, Comparator, Outcomes, and Study Designs (PICOS) strategy, randomized controlled trials were searched in MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The reference lists of the associated articles were also retrieved. The data were calculated by Rev Man v5.3.0. Results: Eleven publications containing an amount of 2, 099 patients were involved in the study. Two groups did not show a significant difference in the mean age and the number of bladder tumors. The results showed that m-TURB had a greater decrease in postoperative hemoglobin level [mean difference (MD) −0.26, 95% confidence interval (CI) −0.48 to −0.04, P = 0.02] and sodium level (MD −0.36, 95% CI −0.62 to −0.10, P = 0.007) compared with b-TURB. B-TURB spent relatively little in hospitalization time (MD −0.52, 95% CI −0.88 to −0.15, P = 0.005) than m-TURB with the exception of operation time (P = 0.47) and catheterization time (P = 0.19). B-TURB did not show a significant difference in the incidence rate of obturator reflex (P = 0.10), bladder perforation (P = 0.32), postoperative blood transfusion (P = 0.28), and clot retention (P = 0.21) compared with the b-TURB group. Besides, there were no significant difference in terms of muscle tissue sampling (P = 0.43), recurrence-free survival at 6 months (P = 0.68) and 12 months (P = 0.78). Conclusions: B-TURB was more effective than m-TURB in minimizing intraoperative or postoperative bleeding with the smaller loss of hemoglobin and the shorter hospitalization time for patients with NMIBC.
Collapse
Affiliation(s)
- Xin Mao
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhongbao Zhou
- Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Yuanshan Cui
- Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China.,Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yong Zhang
- Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Mingshan Yang
- Department of Urology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| |
Collapse
|
5
|
Bolat D, Yarimoglu S, Aydin ME. Monopolar versus bipolar transurethral resection of lateral wall-located bladder cancer under obturator nerve block: a single center prospective randomized study. Int Braz J Urol 2021; 47:584-593. [PMID: 33621007 PMCID: PMC7993959 DOI: 10.1590/s1677-5538.ibju.2020.0568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/25/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of the present prospective-randomized study was to compare perioperative outcomes and complications of bipolar and monopolar TURBT for lateral wall-located non-muscle invasive bladder cancers (NMIBC) under obturator nerve block (ONB). PATIENTS AND METHODS 80 patients who underwent TURBT for lateral wall-located primary bladder tumors under ONB from March, 2016 to November, 2019 were included in the present study. The patients were randomized equally into two groups; monopolar TUR (M-TURBT) and bipolar TUR (B-TURBT). The primary and secondary outcomes were safety (obturator jerk and bladder perforation) and efficacy (complete tumor resection and sampling of the deep muscle tissue). RESULTS Obturator jerk was detected in 2 patients (5%) in M-TURBT while obturator jerk was not observed during B-TURBT (p=0.494). Bladder perforation was not observed in both groups. All of the patients underwent complete tumor resection. There was no significant difference in muscle tissue sampling (67.5% vs. 72.5%, p=0.626) and thermal tissue damage rates (12.5% vs. 25%, p=0.201). The majority of complications were low-grade and the differences in Clavien grade 1-3 complications between groups were not statistically significant. CONCLUSION In the treatment of lateral-wall located NMIBCs, either M-TURBT or B-TURBT can be safely and effectively performed by combining spinal anesthesia with ONB. Even so, it should be taken into consideration that low-grade postoperative hemorrhagic complications may occur in patients who undergo M-TURBT.
Collapse
Affiliation(s)
- Deniz Bolat
- University of Health Sciences, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Serkan Yarimoglu
- University of Health Sciences, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Mehmet Erhan Aydin
- University of Health Sciences, Bozyaka Training and Research Hospital, Izmir, Turkey
| |
Collapse
|
6
|
Xu J, Zheng J, Ma Y. Monopolar versus bipolar transurethral resection of bladder tumors: An updated systematic review and meta-analysis of existing studies. Medicine (Baltimore) 2020; 99:e21768. [PMID: 32846804 PMCID: PMC7447410 DOI: 10.1097/md.0000000000021768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To compare the efficacy and safety of bipolar and monopolar transurethral resection of bladder tumors (TURBT) in non-muscle invasive bladder cancer (NMIBC) treatment. METHODS This protocol established in this study has been reported following the preferred reporting items for systematic review and meta-analysis protocols. Web of Science, PubMed, EMBASE, and the Cochrane Library were searched for all randomized controlled trials comparing bipolar TURBT and monopolar TURBT in NMIBC treatment until 31st of June 2020. We will use a combination of Medical Subject Heading and free-text terms with various synonyms to search based on the eligibility criteria. Two investigators independently reviewed the included studies and extracted relevant data. The odds ratio and 95% confidence intervals of were used as effect estimate. I-square (I) test, substantial heterogeneity, sensitivity analysis, and publication bias assessment will be performed accordingly. Stata 15.0 and Review Manger 5.3 are used for meta-analysis and systematic review. RESULTS The results will be published in a peer-reviewed journal. CONCLUSION The results of this review will be widely disseminated through peer-reviewed publications and conference presentations. This evidence may also provide helpful evidence of the efficacy and safety of bipolar and monopolar transurethral resection of TURBT in NMIBC treatment. PROSPERO REGISTRATION NUMBER CRD42020151997.
Collapse
Affiliation(s)
- Jianeng Xu
- Urology Surgery Department, Jiashan First People's Hospital, Jiashan City, Zhejiang Province
| | - Junbiao Zheng
- Urology Surgery Department, Jiashan First People's Hospital, Jiashan City, Zhejiang Province
| | - Yucheng Ma
- Urology Surgery Department, West China Hospital, Nanchong, Sichuan, China
| |
Collapse
|
7
|
Response to comment regarding article with title: ''does bipolar energy provide any advantage over monopolar surgery in transurethral resection of non-muscle invasive bladder tumors? A systematic review and meta-analysis''. World J Urol 2020; 39:4289-4290. [PMID: 32761261 DOI: 10.1007/s00345-020-03396-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022] Open
|
8
|
Yang Y, Liu C, Yang X. Endoscopic Molecular Imaging plus Photoimmunotherapy: A New Strategy for Monitoring and Treatment of Bladder Cancer. MOLECULAR THERAPY-ONCOLYTICS 2020; 18:409-418. [PMID: 32913890 PMCID: PMC7452043 DOI: 10.1016/j.omto.2020.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Due to the high recurrence and progression rate of non-muscle invasive bladder cancer after transurethral resection of bladder tumor, some new optical imaging technologies have arisen as auxiliary imaging modes for white light cystoscopy to improve the detection rate of small or occult tumor lesions, such as photodynamic diagnosis, narrow-band imaging, and molecular imaging. White light cystoscopy is inadequate and imperfect for bladder cancer detection, and thus residual tumors or coexisting flat malignant lesions, especially carcinoma in situ, would be ignored during conventional resection. The bladder, a hollow organ with high compliance, provides an ideal closed operation darkroom for endoscopic molecular imaging free from interference of external light sources. Also, intravesical instillation of a molecular fluorescent tracer is simple and convenient before surgery through the urethra. Molecular fluorescent tracer has high sensitivity and specificity to tumor cells, and its mediated molecular imaging allows small or occult tumor lesion detection while minimizing false-positive results. Meanwhile, endoscopic molecular imaging provides a real-time and dynamic image during surgery, which helps urologists to perform high-quality and complete tumor resection through accurate judgment of tumor boundaries and depth of invasion. Photoimmunotherapy is a novel molecular targeted therapeutic pattern of photodynamic therapy that kills malignant cells selectively and minimizes the cytotoxicity to normal tissues. The combination of endoscopic molecular imaging and photoimmunotherapy used in initial treatment may avoid the need of repeat transurethral resection in strictly selected patients and improve oncological outcomes such as recurrence-free survival and overall survival after operation.
Collapse
Affiliation(s)
- Yongjun Yang
- First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chao Liu
- First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaofeng Yang
- First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China.,Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| |
Collapse
|
9
|
Does bipolar energy provide any advantage over monopolar surgery in transurethral resection of non-muscle invasive bladder tumors? A systematic review and meta-analysis. World J Urol 2020; 39:1093-1105. [PMID: 32591900 DOI: 10.1007/s00345-020-03313-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/16/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To provide most recent and high quality evidence concerning the comparison between monopolar and bipolar transurethral resection of non-muscle invasive bladder tumors. MATERIALS AND METHODS Two researchers performed a systematic review of the current literature independently, to identify studies published in English language. MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews were searched from inception to 31st May 2019. The included primary endpoints of the study were: detrusor muscle sampling rates, cautery artifact occurrence among specimens and 1- or 2-year recurrence rates, overall complication rate, transfusion rate, obturator reflex and bladder perforation rates. Secondary endpoints were length of hospital stay, operation room time, hemoglobin drop, urinary tract infections, TUR-syndrome, serum sodium drop and acute urinary retention rates. RESULTS 23 studies (14 RCTs and 9 observational) were included for qualitative and quantitative synthesis, recruiting 9815 patients in monopolar resection group and 10,112 patients in bipolar resection group (experimental). We found significant differences in favor of bipolar energy in terms of cautery artifact and length of stay with bladder perforation rates were found to be significantly better in bipolar system even though these results did not sustain when RCT's only analysis was performed. No differences were found in rates of obturator reflex (even though RCT's analysis advised differently), tumor recurrence and most of the secondary endpoints. CONCLUSIONS Bipolar transurethral bladder tumor resection is as safe and efficient as its monopolar counterpart. Bipolar technology is related to less obturator nerve contractions and less tissue thermal artifacts during resection and may result in less hospital stay.
Collapse
|
10
|
Bipolar versus monopolar transurethral resection of non-muscle-invasive bladder cancer: a systematic review and meta-analysis of randomized controlled trials. World J Urol 2020; 39:1177-1186. [PMID: 32462303 DOI: 10.1007/s00345-020-03271-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/18/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To compare the efficacy and safety of bipolar and monopolar transurethral resection of bladder tumors (TURBT) in non-muscle invasive bladder cancer (NMIBC) treatment. METHODS A systematic search of all Randomized Controlled Trials (RCTs), which compared bipolar TURBT (bTURBT) and monopolar TURBT (mTURBT) in NMIBC treatment, were performed in PubMed, Web of Science, Cochrane Library and Embase up to February 1, 2019. We evaluated their efficacy by operative time, hospitalization time, catheterization time, and recurrence rate. While obturator jerk, bladder perforation, thermal damage, and overall complications were used to evaluate their safety. RESULTS A total of 13 RCTs, involving 2379 patients, were included. There were no statistically significant differences in efficacy between bTURBT and mTURBT in NMIBC treatment, such as operative time (p = 0.12), hospitalization time (p = 0.13), catheterization time (p = 0.50), and recurrence rate (p = 0.88). Compared to the safety in mTURBT in NMIBC treatment, no significant advantages were observed in that in bTURBT as well, such as obturator jerk (p = 0.12), bladder perforation (p = 0.11), thermal damage (p = 0.24), and overall complications (p = 0.65). CONCLUSIONS Our analysis demonstrated that bTURBT has no significant advantages in efficacy and safety in NMIBC treatment compared to that in mTURBT. Thus, bTURBT could not completely replace mTURBT as a safer and more effective NMIBC treatment.
Collapse
|
11
|
Zhou Z, Gao Z, Wu J, Cui Y. Safety and efficacy of bipolar versus monopolar transurethral resection of bladder tumor: a systematic review and meta-analysis. World J Urol 2020; 39:2249-2250. [PMID: 32430569 DOI: 10.1007/s00345-020-03248-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Zhongbao Zhou
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China
| | - Zhenli Gao
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China
| | - Jitao Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China. .,Department of Urology, Beijing TianTan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
| |
Collapse
|
12
|
Current European Trends in Endoscopic Imaging and Transurethral Resection of Bladder Tumors. J Endourol 2020; 34:312-321. [DOI: 10.1089/end.2019.0651] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
|
13
|
Technical developments in transurethral resection of bladder tumours. Contemp Oncol (Pozn) 2019; 23:195-201. [PMID: 31992950 PMCID: PMC6978765 DOI: 10.5114/wo.2019.91530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/04/2019] [Indexed: 11/26/2022] Open
Abstract
Bladder cancer is one of the most common malignancies worldwide. The transurethral resection of bladder tumour (TURB) remains the gold standard in both diagnostics and treatment. Because of the importance of TURB in bladder cancer management and the fact that TURB is one of the most commonly performed urologic procedures, it is the subject of continuous technological development. The latest advances in the field of endourology are aimed at increasing surgical accuracy and thus reducing the risk of bladder tumour recurrence and progression. However, despite the constant progress in technology and technique, there are still a lack of good quality data showing the superiority of any of the methods. The aim of this paper is to present available data on new technological developments in surgical technique of TURB. Advantages and disadvantages of currently available methods are discussed, and literature showing their effectiveness and safety is shown.
Collapse
|
14
|
Current concept of transurethral resection of bladder cancer: from re-transurethral resection of bladder cancer to en-bloc resection. Curr Opin Urol 2019; 28:591-597. [PMID: 30102624 DOI: 10.1097/mou.0000000000000542] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Transurethral resection of bladder cancer (TURB) is the critical step in the management of nonmuscle invasive bladder cancer (NMIBC). This review presents new improvements in the strategy and technique of TURB as well as in technological developments used for tumour visualization and removal. RECENT FINDINGS The goal of TURB is to perform complete resection of NMIBC. Tumor visualization during procedure can be improved by enhanced optical technologies. Fluorescence-guided photodynamic diagnosis (PDD) and narrow-band imaging (NBI) used during TURB can improve tumour detection and potentially reduce recurrence rate, their influence on progression, however, remains controversial. TURB can be performed using monopolar or bipolar electrocautery without significant differences in results or safety. To overcome limitations of traditional TURB, the technique of en-bloc resection was introduced to improve the quality of tumour removal. In selected cases, an early re-resection (re-TURB) within 2-6 weeks after initial procedure is recommended. SUMMARY TURB is a fundamental step in diagnosis and treatment of NMIBC. Urologists should be aware of promising innovations including new imaging and surgical techniques and their potential benefits. Hopefully, new technologies and performance of TURB bring improved outcomes, which can alter the indication criteria for re-TURB.
Collapse
|
15
|
Mahmoud MA, Tawfick A, Mostafa DE, Elawady H, Abuelnaga M, Omar K, Elshawaf H, Hasan M. Can bipolar energy serve as an alternative to monopolar energy in the management of large bladder tumours >3 cm? A prospective randomised study. Arab J Urol 2019; 17:125-131. [PMID: 31285924 PMCID: PMC6600073 DOI: 10.1080/2090598x.2019.1590517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/24/2018] [Indexed: 10/31/2022] Open
Abstract
Objectives: To assess the safety and the effectiveness of bipolar energy in the transurethral resection of primary large bladder tumours (TURBT) and compare it to conventional monopolar energy. Patients and methods: From November 2015 to June 2017, 80 patients underwent endoscopic resection primarily for large bladder cancer tumours of >3 cm. They were randomly assigned into two groups: 40 patients underwent a TURBT with conventional monopolar current (M-TURBT) and 40 were treated with bipolar current (B-TURBT). Results: There were no statistically significant differences between the two groups for the patients' demographic and tumour characteristics. There was a significant difference between M-TURBT and B-TURBT for resection time, obturator reflex, hospital stay, and catheterisation time, which were all higher in the M-TURBT group; the mean (SD) resection time was 26.45 (5.73) vs 22.85 (7.52) min (P = 0.048), the obturator reflex was 25% vs 5% (P = 0.025), the median hospital stay and catheterisation times were 2 vs 1 day (P = 0.012 and P = 0.023, respectively). No statistically significant difference was found between the groups for bladder perforation, TUR syndrome, drop in haemoglobin level, and blood transfusion rate. However, there was statically significant difference in the postoperative haematuria rate, which was higher in the M-TURBT group, at 24 patients vs eight in the B-TURBT group (60% vs 20%; P = 0.01). After 1-year follow-up, there was no significant difference in the recurrence rate between the groups. Conclusion: B-TURBT is a safe and effective alternative procedure to M-TURBT for the management of primary large bladder tumours of >3 cm. Abbreviations: CONSORT: consolidated standards of reporting Trials; Hb: haemoglobin; NMIBC: non-muscle-invasive bladder cancer; TUR: transurethral resection; (B-)(M-)TURBT: (bipolar) (monopolar) transurethral resection of bladder tumour.
Collapse
Affiliation(s)
| | - Ahmed Tawfick
- Department of Urology, Ain Shams University Hospital, Cairo, Egypt
| | | | - Hossam Elawady
- Department of Urology, Ain Shams University Hospital, Cairo, Egypt
| | | | - Karim Omar
- Department of Urology, Ain Shams University Hospital, Cairo, Egypt
| | - Hisham Elshawaf
- Department of Urology, Ain Shams University Hospital, Cairo, Egypt
| | - Mohamed Hasan
- Department of Urology, Ain Shams University Hospital, Cairo, Egypt
| |
Collapse
|
16
|
Gunlusoy B, Bolat D, Degirmenci T. Re: “Monopolar vs. bipolar transurethral resection for nonmuscle invasive bladder carcinoma: A post hoc analysis from a randomized controlled trial”. Urol Oncol 2019; 37:177-178. [DOI: 10.1016/j.urolonc.2018.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
|