Oswald D, Pallauf P, Deininger S, Herrmann T R W, Netsch C, Becker B, Fiedler M, Haecker A, Homberg R, Klein J T, Lehrich K, Miernik A, Olbert P, Schöb D S, Sievert K D, Gross A J, Westphal J, Lusuardi L
Universitätsklink für Urologie und Andrologie, Paracelsus Medizinische Universität Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Österreich.
Urologie, Kantonsspital Frauenfeld, Frauenfeld, Schweiz.
Urologie. 2022 Jun;61(6):644-652. doi: 10.1007/s00120-022-01765-z. Epub 2022 Mar 14.
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.
To analyze current data on ERBT in efficacy and safety compared to cTURBT.
PubMed.
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.
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.
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.
膀胱肿瘤整块切除（ERBT）是一种相对于传统膀胱肿瘤切除术（cTURBT）的新型替代手术，它可能有助于解决标准方法的常见问题，如标本中逼尿肌不足、高再次切除率和高复发率。
分析与cTURBT相比，ERBT在疗效和安全性方面的现有数据。
PubMed。
两位独立作者根据关键词和纳入标准确定试验。如有分歧，会咨询第三位作者。筛选关键词：ERBT、经尿道膀胱肿瘤整块切除术、整块TURBT。对13项研究进行了荟萃分析。基于优势比和平均差异估计效应大小，包括其相应的双侧95%置信区间。
分析的研究在肿瘤大小、肿瘤多灶性和肿瘤分期方面构成了一个同质群体。两种方法的手术时间无显著差异。在住院时间和导尿时间方面观察到差异，ERBT更具优势。报告的并发症未显示明显差异。ERBT组标本中的逼尿肌明显更多。在长达2年的随访中，复发率无显著差异。
ERBT是传统TURBT的一种安全替代方法，在有效切除逼尿肌方面具有良好前景。需要更多关于复发率、不同切除方式和切缘结果的标准化数据。
