Schraml Jan, Silva Joana Do Carmo, Babjuk Marko
Department of Urology, Masaryk Hospital, Ústí nad Labem.
Department of Urology, Hospital Motol and 2nd Faculty of Medicine, Charles University, Praha, Czech Republic.
Curr Opin Urol. 2018 Nov;28(6):591-597. doi: 10.1097/MOU.0000000000000542.
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.
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.
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.
经尿道膀胱肿瘤切除术（TURB）是非肌层浸润性膀胱癌（NMIBC）治疗中的关键步骤。本综述介绍了TURB在策略、技术以及用于肿瘤可视化和切除的技术发展方面的新进展。
TURB的目标是完全切除NMIBC。术中可通过增强光学技术改善肿瘤可视化。TURB期间使用的荧光引导光动力诊断（PDD）和窄带成像（NBI）可改善肿瘤检测并可能降低复发率，然而，它们对疾病进展的影响仍存在争议。TURB可使用单极或双极电灼进行，结果或安全性方面无显著差异。为克服传统TURB的局限性，引入了整块切除技术以提高肿瘤切除质量。在特定情况下，建议在初次手术后2 - 6周内尽早进行再次切除（再次TURB）。
TURB是NMIBC诊断和治疗的基本步骤。泌尿外科医生应了解包括新成像和手术技术及其潜在益处在内的有前景创新。希望新技术和TURB的性能能带来更好的结果，这可能会改变再次TURB的指征标准。
