Transurethral „en bloc“ resection technique in non-muscle invasive bladder cancer

Abstract

ABSTRACT.

Introduction. Transurethral resection of the bladder tumours (TURBT) is the standard approach to bladder tumour removal; however, it has several disadvantages.

The objective of the study was to evaluate the safety and efficacy of „en bloc“ resection of non-muscle invasive bladder tumours (ERBT) by using the conventional monopolar „Hook“ resection electrode.

Material and methods. ERBT and TURBT procedures were conducted in 67 and in 85 patients respectively, diagnosed with superficial bladder tumours. In the ERBT group, the tumours were removed retrograde en bloc, under direct vision, via a conventional monopolar „Hook“ electrode. Clinical pathological, intra-operative and post-operative patients’ data were compared retrospectively between both groups (ERBT and TURBT).

Results. Of the 152 patients, 67 underwent ERBT and 85 were treated with TURBT. Both groups were comparable in clinical characteristics. ERBT has been performed as safely and effectively as TURBT. There were no significant differences in the operative time and intraoperative or postoperative surgical complications. The comparative recurrence rates were similar for both groups during up to 24-month follow-up. The detrusor muscle fibers were histologically identified in 100% of ERBT tumour samples and marginal tumour bases, and only in 80% of post-TURBT samples.

Conclusions. ERBT is a feasible and safe technique for removing superficial bladder tumours using a monopolar „Hook“ resection, with the same advantages of a proper tumour resection, as well as possibility to collect good quality tumour samples and bladder tumour base specimen for pathological diagnosis and staging compared to standard TURBT.