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Les complications chirurgicales en urologie adulte : chirurgie de la vessie. Prog Urol 2022; 32:940-952. [DOI: 10.1016/j.purol.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/20/2022]
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Kaynar M, Celik ZE, Altintas E, Batur AF, Kilic O, Akand M, Gul M, Goktas S. Comparison of Two Different Bipolar Energy Resources in Transurethral Resection of Bladder Tumors. Urol Int 2021; 105:304-308. [PMID: 33454714 DOI: 10.1159/000512380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/18/2020] [Indexed: 12/09/2022]
Abstract
PURPOSE To determine whether the use of different bipolar resources is associated with different results on tissue and perioperative parameters in patients undergoing bipolar transurethral bladder tumor resection (bTURBT). METHODS In this single-center prospective study, patients diagnosed with bladder tumor randomized to undergo TURBT either with a Gyrus PlasmaKinetic system (n = 62) or Olympus TUR in saline (TURis) system (n = 51). Primary endpoint was to evaluate the alteration of patients' perioperative parameters, while secondary aim was to assess the thermal effect of these 2 different bipolar devices on the resected tissue samples by a grading system determined by tissue characteristics. RESULTS One hundred thirteen patients were randomized in the study, and 43 were excluded from the analysis due to the exclusion criteria. There were no significant differences between the groups in terms of mean age, tumor site, number of tumors, operative time, alteration in hemoglobin or hematocrit, blood transfusion rate, catheterization time, and postoperative stay. On the other hand, the ratio of obturator jerk was significantly higher in the Olympus TURis group (p = 0.028). The histopathological analyses of both groups determined muscularis propria and cautery artifact presence without a statistically significant difference (χ2: 0.476, p = 0.788). CONCLUSION Although the perioperative complications of bTURBT are low in nature, bladder perforation resulted from obturator jerk still poses a risk for extravesical tumor implantation. Urologists should be aware of this risk especially when they are using a TURis system.
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Affiliation(s)
- Mehmet Kaynar
- Department of Urology, School of Medicine, Selcuk University, Konya, Turkey
| | - Zeliha Esin Celik
- Department of Pathology, School of Medicine, Selcuk University, Konya, Turkey
| | - Emre Altintas
- Department of Urology, Akcakale State Hospital, Sanliurfa, Turkey
| | - Ali Furkan Batur
- Department of Urology, School of Medicine, Selcuk University, Konya, Turkey
| | - Ozcan Kilic
- Department of Urology, School of Medicine, Selcuk University, Konya, Turkey
| | - Murat Akand
- Department of Urology, School of Medicine, Selcuk University, Konya, Turkey
| | - Murat Gul
- Department of Urology, School of Medicine, Selcuk University, Konya, Turkey,
| | - Serdar Goktas
- Department of Urology, School of Medicine, Selcuk University, Konya, Turkey
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Accurate Quantification of Residual Cancer Cells in Pelvic Washing Reveals Association with Cancer Recurrence Following Robot-Assisted Radical Cystectomy. J Urol 2019; 201:1105-1114. [PMID: 30730413 DOI: 10.1097/ju.0000000000000142] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Bladder cancer recurrence following cystectomy remains a significant cause of bladder cancer specific mortality. Residual cancer cells contribute to cancer recurrence due to tumor spillage or undetectable preexisting micrometastatic tumor clones. We detected and quantified residual cancer cells in pelvic washing using ultradeep targeted sequencing. We compared the levels of residual cancer cells with clinical variables and cancer recurrence. MATERIALS AND METHODS The primary tumor specimen was available in 17 patients who underwent robot-assisted radical cystectomy. All tumors had negative surgical margins. Pelvic washes and blood were collected intraoperatively before and after robot-assisted radical cystectomy, after pelvic lymph node dissection and in the suction fluid collected during the procedure. Two-step sequencing, including whole exome sequencing followed by ultradeep targeted sequencing (× greater than 50,000), was done to quantify residual cancer cells in each sample. Eight patients were excluded from study due to sample quality issues. The final analysis cohort comprised 9 patients. The residual cancer cell level was quantified for each sample as the relative cancer cell fraction and compared between time points. The peak relative cancer cell fraction of each patient was correlated with clinical and pathological variables. RESULTS Residual cancer cells were detected in approximately half of the pelvic washing specimens during or after but not before robot-assisted radical cystectomy. Higher residual cancer cell levels were associated with aggressive variant histology and cancer recurrence. Verifying the feasibility of using residual cancer cells as a novel biomarker for recurrence requires larger cohorts. CONCLUSIONS Detection of residual cancer cells in intraoperative peritoneal washes of patients with bladder cancer who undergo radical cystectomy may represent a robust biomarker of tumor aggressiveness and metastatic potential.
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Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium. J Urol 2016; 197:1427-1436. [PMID: 27993668 DOI: 10.1016/j.juro.2016.12.048] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE We sought to investigate the prevalence and variables associated with early oncologic failure. MATERIALS AND METHODS We retrospectively reviewed the IRCC (International Radical Cystectomy Consortium) database of patients who underwent robot-assisted radical cystectomy since 2003. The final cohort comprised a total of 1,894 patients from 23 institutions in 11 countries. Early oncologic failure was defined as any disease relapse within 3 months of robot-assisted radical cystectomy. All institutions were surveyed for the pneumoperitoneum pressure used, breach of oncologic surgical principles, and techniques of specimen and lymph node removal. A multivariate model was fit to evaluate predictors of early oncologic failure. The Kaplan-Meier method was applied to depict disease specific and overall survival, and Cox proportional regression analysis was used to evaluate predictors of disease specific and overall survival. RESULTS A total of 305 patients (22%) experienced disease relapse, which was distant in 220 (16%), local recurrence in 154 (11%), peritoneal carcinomatosis in 17 (1%) and port site recurrence in 5 (0.4%). Early oncologic failure developed in 71 patients (5%) at a total of 10 institutions. The incidence of early oncologic failure decreased from 10% in 2006 to 6% in 2015. On multivariate analysis the presence of any complication (OR 2.87, 95% CI 1.38-5.96, p = 0.004), pT3 or greater disease (OR 3.73, 95% CI 2.00-6.97, p <0.001) and nodal involvement (OR 2.14, 95% CI 1.21-3.80, p = 0.008) was a significant predictor of early oncologic failure. Patients with early oncologic failure demonstrated worse disease specific and overall survival (23% and 13%, respectively) at 1 and 3 years compared to patients who experienced later or no recurrences (log rank p <0.001). CONCLUSIONS The incidence of early oncologic failure following robot-assisted radical cystectomy has decreased with time. Disease related rather than technical related factors have a major role in early oncologic failure after robot-assisted radical cystectomy.
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Osman Y, Harraz AM. A Review Comparing Experience and Results with Bipolar Versus Monopolar Resection for Treatment of Bladder Tumors. Curr Urol Rep 2016; 17:21. [DOI: 10.1007/s11934-016-0579-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Comparison of Perioperative Outcomes including Severe Bladder Injury between Monopolar and Bipolar Transurethral Resection of Bladder Tumors: A Population Based Comparison. J Urol 2014; 192:1355-9. [DOI: 10.1016/j.juro.2014.05.100] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2014] [Indexed: 11/17/2022]
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Higuchi T, Burcham GN, Childress MO, Rohleder JJ, Bonney PL, Ramos-Vara JA, Knapp DW. Characterization and treatment of transitional cell carcinoma of the abdominal wall in dogs: 24 cases (1985–2010). J Am Vet Med Assoc 2013; 242:499-506. [DOI: 10.2460/javma.242.4.499] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bus MT, Cordeiro ER, Anastasiadis A, Klioueva NM, de la Rosette JJ, de Reijke TM. Urothelial carcinoma in both adnexa following perforation during transurethral resection of a non-muscle-invasive bladder tumor: a case report and literature review. Expert Rev Anticancer Ther 2012; 12:1529-36. [PMID: 23253219 DOI: 10.1586/era.12.136] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this article case report of urothelial carcinoma implantation in both adnexa is reported, following a perforation of the bladder wall during a transurethral resection of a bladder tumor. The 81-year-old female patient had an extensive history of multiple recurrent non-muscle-invasive urothelial carcinoma of the bladder. Intraperitoneal perforation was detected and managed conservatively. Fifteen months after the procedure, the patient presented at the gynecology department with a mass in the left adnex, which was suspicious for malignancy, for which she subsequently underwent hysterectomy in combination with bilateral resection of the adnexa. Pathology showed papillary urothelial carcinoma in both ovaries. A literature search was performed to present an up-to-date review of the available data on bladder perforations during transurethral resection of the bladder and tumor implantation, its management and oncological outcomes.
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Affiliation(s)
- Mieke T Bus
- Department of Urology, Academic Medical Center, Amsterdam, The Netherlands
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Herkommer K, Hofer C, Gschwend JE, Kron M, Treiber U. Gender and Body Mass Index as Risk Factors for Bladder Perforation During Primary Transurethral Resection of Bladder Tumors. J Urol 2012; 187:1566-70. [DOI: 10.1016/j.juro.2011.12.114] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Indexed: 10/28/2022]
Affiliation(s)
- Kathleen Herkommer
- Department of Urology, Technische Universität München, Klinikum rechts der Isar, Munich and Institute of Biometrics, University of Ulm (MK), Ulm, Germany
| | - Christian Hofer
- Department of Urology, Technische Universität München, Klinikum rechts der Isar, Munich and Institute of Biometrics, University of Ulm (MK), Ulm, Germany
| | - Juergen E. Gschwend
- Department of Urology, Technische Universität München, Klinikum rechts der Isar, Munich and Institute of Biometrics, University of Ulm (MK), Ulm, Germany
| | - Martina Kron
- Department of Urology, Technische Universität München, Klinikum rechts der Isar, Munich and Institute of Biometrics, University of Ulm (MK), Ulm, Germany
| | - Uwe Treiber
- Department of Urology, Technische Universität München, Klinikum rechts der Isar, Munich and Institute of Biometrics, University of Ulm (MK), Ulm, Germany
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Golan S, Baniel J, Lask D, Livne PM, Yossepowitch O. Transurethral resection of bladder tumour complicated by perforation requiring open surgical repair - clinical characteristics and oncological outcomes. BJU Int 2010; 107:1065-8. [DOI: 10.1111/j.1464-410x.2010.09696.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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El Hayek OR, Coelho RF, Dall'oglio MF, Murta CB, Ribeiro Filho LA, Nunes RLV, Chade D, Menezes M, Srougi M. Evaluation of the incidence of bladder perforation after transurethral bladder tumor resection in a residency setting. J Endourol 2009; 23:1183-6. [PMID: 19530900 DOI: 10.1089/end.2008.0406] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To evaluate prospectively the actual bladder perforation incidence during transurethral resection of bladder tumor (TURB) performed by residents and to identify possible predisposing factors to such condition. PATIENTS AND METHODS Thirty-four patients with bladder tumor were submitted to TURB in our academic institution in April 2006, and were prospectively studied. Procedures were all done by senior residents under an attending direct supervision. All patients had a cystograms performed after the procedure by the injection of 400 mL of saline-diluted contrast solution with low-pressure infusion through the Foley catheter. The cystograms were evaluated blindly by a single radiologist. All patients were examined by cystoscopy and/or CT every 3 months for the first 2 years postoperatively. RESULTS The cystogram showed contrast leaking compatible with bladder perforation in 17 (50%) cases. None of the perforations were recognized intraoperatively by the surgeon. All perforations were extraperitoneal and managed conservatively. There was no significant correlation between the incidence of bladder perforation and the patient age (p = 0.508), the tumor stage (p = 0.998), the tumor grade (p = 0.833), the number of lesions (p = 0.394), and the tumor size (p = 0.651). The only factor that had impact on the development of bladder perforation was tumor localization at the bottom of the bladder (p = 0.035; OR, 6750; 95% CI, 1.14, 39.8). CONCLUSION Asymptomatic perforations of the bladder wall occur very frequently after a TURB procedure performed by residents in training and, most of the time, are not noticed by the surgeon. Localization of the tumor at bladder dome was the only factor that negatively influenced perforation rates.
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Affiliation(s)
- Omar R El Hayek
- Divisão de Clínica Urológica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Prevention and treatment of transitional cell carcinomatosis with intraperitoneal chemotherapy in a rat model. J Urol 2009; 181:1901-6. [PMID: 19237166 DOI: 10.1016/j.juro.2008.11.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Indexed: 11/22/2022]
Abstract
PURPOSE Tumor spillage from bladder perforation during transurethral bladder tumor resection or cystectomy risks seeding the peritoneum with transitional cell carcinoma. We determined the lowest effective mitomycin C dose to prevent tumor implantation and the potential efficacy of delayed therapy. Additionally, we investigated the effect of tumor debulking combined with intraperitoneal mitomycin C. MATERIALS AND METHODS Using our established murine model of intraperitoneal transitional cell carcinoma implantation mitomycin C was instilled at decreasing concentrations to find the lowest effective dose. To evaluate the effectiveness of delayed therapy mitomycin C was administered on day 3 or 7 after tumor implantation. Finally, surgical debulking of established tumors with or without mitomycin C was performed. RESULTS All control animals had disseminated carcinomatosis. The lowest effective intraperitoneal mitomycin C dose to prevent implantation was 0.3125 mg/m(2). Administration of mitomycin C on day 3 after instillation resulted in tumor-free status in 50% of the animals, although no rats were tumor-free when treated on day 7. Tumor debulking only for established disease cured 40% of the animals, whereas debulking combined with mitomycin C had a 100% cure rate. CONCLUSIONS Intraperitoneal mitomycin C prevents tumor growth after transitional cell carcinoma implantation. Delayed therapy is not as effective as immediate treatment but cure is still possible, particularly when combined with surgical debulking, in a rat model.
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Abaza R, Keck RW, Selman SH. Intraperitoneal Chemotherapy for the Prevention of Transitional Cell Carcinoma Implantation. J Urol 2006; 175:2317-22. [PMID: 16697866 DOI: 10.1016/s0022-5347(06)00257-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2005] [Indexed: 11/26/2022]
Abstract
PURPOSE Tumor spillage from bladder perforation during transurethral resection of a bladder tumor or during cystectomy risks seeding the peritoneum with TCC. Current therapy is irrigation with sterile water with an unknown extent of clinical benefit. Intraperitoneal chemotherapy for other human cancers has demonstrable benefit but to our knowledge it has never been investigated for TCC. We investigated whether intraperitoneal chemotherapy can prevent TCC implantation in a murine model of tumor spillage and whether water irrigation is beneficial. MATERIALS AND METHODS Laparotomy was performed in 28 Fischer 344 rats (National Cancer Institute, Frederick, Maryland) to instill 1 x 10 AY-27 TCC cells. Mitomycin (10 mg/m) was instilled in 9 rats and saline was used in the control group. A third group underwent lavage with sterile water. At sacrifice after 2 weeks tumors were measured in mm and weighed. A followup experiment of 4-week survival used 5 mg/m mitomycin and added a fourth group treated with water lavage plus mitomycin. RESULTS All 9 rats in the saline control group had gross tumors at the laparotomy site as well as gross carcinomatosis. The 10 water lavage rats also demonstrated gross tumors but of smaller size (p = 0.02). All rats treated with mitomycin had no gross or microscopic evidence of tumor growth anywhere in the peritoneum. In experiment 2 none of the rats treated with lower dose mitomycin had gross or microscopic tumors regardless of water lavage. CONCLUSIONS Intraperitoneal chemotherapy prevents TCC implantation in a murine model of tumor spillage. Water lavage decreases the tumor burden but it cannot effectively sterilize the peritoneum of tumor.
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Affiliation(s)
- Ronney Abaza
- Department of Urology, Medical University of Ohio, Toledo, Ohio, USA
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Balbay MD, Cimentepe E, Unsal A, Bayrak O, Koç A, Akbulut Z. THE ACTUAL INCIDENCE OF BLADDER PERFORATION FOLLOWING TRANSURETHRAL BLADDER SURGERY. J Urol 2005; 174:2260-2, discussion 2262-3. [PMID: 16280794 DOI: 10.1097/01.ju.0000181811.61199.35] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE In this prospective study we evaluated the incidence of bladder perforation after transurethral bladder tumor resection. MATERIALS AND METHODS A total of 36 patients (33 male, 3 female, mean age +/- SD 65.6 +/- 11.43 [range 26 to 81]) with a solid mass in the bladder (mean 20.3 +/- 8.7 mm, range 5 to 40) were included in the study. Transurethral resections were performed with a 24Fr resectoscope. After the procedure an 18Fr Foley catheter was inserted into the bladder and 400 ml of 1/4 saline diluted contrast solution was instilled under gravity from 60 cm above the bladder. Complete filling and post-drainage radiographs were taken and examined for any evidence of extravasation. Regular evaluations with cystoscopy and ultrasound/computerized tomography were done to detect possible tumor recurrence and perivesical seeding. RESULTS Histopathological examination of the tumors showed transitional cell carcinoma in 35 patients and chronic eosinophilic cystitis in 1. Review of the cystograms revealed various degrees of extraperitoneal contrast extravasation around the resected area in 21 patients (58.3%). The only statistically significant difference between patients with and without extravasation was in tumor size (logistic stepwise regression p = 0.030,) among factors tested including patient age and localization, number of foci, tumor grade and stage. No apparent clinical problems requiring medical or surgical intervention other than urethral catheterization developed and no evidence of extravesical tumor seeding as per ultrasound and/or computerized tomography was seen during a mean followup of 21.9 months (range 7 to 40). CONCLUSIONS The extravasation of urine (asymptomatic perforation) after transurethral bladder tumor resection may occur much more frequently than believed or reported. It seems that this extravasation does not impose a significant risk of extravesical tumor seeding.
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Affiliation(s)
- M Derya Balbay
- Atatürk Training and Research Hospital, 1st Urology Clinic and Department of Urology, Fatih University School of Medicine, Ankara, Turkey.
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Skolarikos A, Chrisofos M, Ferakis N, Papatsoris A, Dellis A, Deliveliotis C. DOES THE MANAGEMENT OF BLADDER PERFORATION DURING TRANSURETHRAL RESECTION OF SUPERFICIAL BLADDER TUMORS PREDISPOSE TO EXTRAVESICAL TUMOR RECURRENCE? J Urol 2005; 173:1908-11. [PMID: 15879773 DOI: 10.1097/01.ju.0000158450.71497.ae] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We evaluated the impact of a bladder perforation during transurethral resection of superficial bladder tumor on extravesical tumor recurrence and patient prognosis. We also defined potential risk factors for extravesical recurrence prospectively giving emphasis to the management of the perforation. MATERIALS AND METHODS The medical records of 3,410 patients were reviewed. Parameters recorded included patient age and sex, tumor stage, grade, number, size and location at the time of perforation, the type of bladder perforation (extraperitoneal vs intraperitoneal) and the way the perforation was managed (open surgical repair vs conservative treatment). Logistic regression analysis was used to identify risk factors for extravesical recurrence. Cox regression analysis was used to compare cancer specific survival. RESULTS A total of 34 cases of bladder perforation were recorded, 4 patients were treated with open surgery and 30 treated conservatively. The 4 patients who underwent open surgery presented with extravesical recurrence after a mean followup of 7.5 months. The remaining 30 patients had no evidence of extravesical recurrence after a mean followup of 60 months (p <0.001). Of the patients with extravesical relapse 3 died of disease. The surgical management of bladder perforation was the best predictor of extravesical recurrence (p <0.001, r = 1.13), followed by an intraperitoneal localization of the perforation (p =0.0003, r = 0.67) and tumor size (p =0.01, r = 0.42). CONCLUSIONS Surgical repair of a bladder perforation during transurethral resection of bladder tumor increases the risk of extravesical tumor cell recurrence and negatively affects patient prognosis.
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MESH Headings
- Administration, Intravesical
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Carcinoma, Transitional Cell/mortality
- Carcinoma, Transitional Cell/pathology
- Carcinoma, Transitional Cell/secondary
- Carcinoma, Transitional Cell/surgery
- Cause of Death
- Cystoscopy/adverse effects
- Female
- Follow-Up Studies
- Humans
- Logistic Models
- Male
- Middle Aged
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Neoplasm Seeding
- Peritoneal Neoplasms/mortality
- Peritoneal Neoplasms/pathology
- Peritoneal Neoplasms/secondary
- Peritoneal Neoplasms/surgery
- Postoperative Complications/mortality
- Postoperative Complications/pathology
- Postoperative Complications/surgery
- Proportional Hazards Models
- Reoperation
- Retrospective Studies
- Risk Factors
- Survival Rate
- Urinary Bladder/injuries
- Urinary Bladder/pathology
- Urinary Bladder/surgery
- Urinary Bladder Neoplasms/mortality
- Urinary Bladder Neoplasms/pathology
- Urinary Bladder Neoplasms/surgery
- Wounds, Penetrating/complications
- Wounds, Penetrating/mortality
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Affiliation(s)
- Andreas Skolarikos
- 2nd Department Of Urology, School of Medicine, University of Athens, Sismanoglio General Hospital Athens, Greece
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Manikandan R, Lynch N, Grills RJ. Percutaneous peritoneal drainage for intraperitoneal bladder perforations during transurethral resection of bladder tumors. J Endourol 2004; 17:945-7. [PMID: 14744369 DOI: 10.1089/089277903772036343] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To demonstrate the safety and efficacy of percutaneous drainage of the peritoneal cavity using an 8F pigtail catheter placed under ultrasound guidance in cases of intraperitoneal perforation of the bladder as a result of transurethral resection of a bladder tumor (TURBT). PATIENTS AND METHODS Three patients undergoing TURBT had inadvertent but significant intraperitoneal perforations of the bladder. All patients developed signs and symptoms of peritonism despite large catheters draining the bladder. An 8F pigtail catheter (Boston Scientific, Watertown, MD, USA) was inserted percutaneously under ultrasound guidance with local anesthetic infiltration. RESULTS All three patients made a good recovery without needing a laparotomy. Cystograms a week later confirmed an intact bladder. Clinical review revealed no sequelae as a result of the perforation or its treatment. CONCLUSION Percutaneous drainage of the abdomen in patients with intraperitoneal perforation of the bladder during TURBT is a safe alternative to laparotomy.
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Affiliation(s)
- Ramaswamy Manikandan
- Department of Urology, Basquill House, Stepping Hill Hospital, Stockport SK2 7JE, U.K.
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