Kannan Deerush, Sekaran Praveen G, Sankaran Sindhu, Taur Pratik, J Sanjay Prakash, Paul Rajesh, Thangarasu Mathisekaran, Jain Nitesh
Urology, Apollo Hospitals, Chennai, IND.
General Surgery, Saveetha Medical College and Hospital, Chennai, IND.
Cureus. 2023 Jul 26;15(7):e42523. doi: 10.7759/cureus.42523. eCollection 2023 Jul.
Background En-bloc transurethral resection of bladder tissue (ETURBT) has recently been proposed as a good alternative technique to trans-urethral resection of bladder tissue (TURBT) in terms of outcomes for bladder carcinoma. This study aims to assess the effectiveness of the technique in terms of clinical, pathological and oncological outcomes. Methodology In this prospective study, data was collected from patients who underwent ETURBT for bladder space-occupying lesions between June 2021 and June 2022. Demographic characteristics, tumour characteristics, and postoperative outcomes were recorded. Results A total of 52 patients were studied with the majority being male and a mean age of 50.87 years. Smoking was recorded in 22 (38.5%) patients and 8 (15.4%) were on antiplatelet therapy. The majority fell in the American Society of Anesthesiology (ASA) class I (59.6%). Most of the tumours were solitary (90.4%), primary (82.8%), papillary architecture (73.1%), and between 1-3 cm in size. The lateral wall was the most common position, and detrusor muscle was seen in 98.1% of the specimens. T1 stage (57.7%) and low grade (67.3%) were the common characteristics noted. 76.9% of the ETURBT was conducted using monopolar cautery. Recurrence was noted in 3 (5.8%) and bladder perforation in 1 patient (1.9%). Cautery artifact was seen in six patients (11.5%) and obturator jerk in nine patients (17.3%). Conclusion Our study suggests that ETURBT is a technique with a good success rate for bladder tumours less than 3 cm in size. The benefits include high chances of detrusor sampling while minimising crush artefacts and cautery damage. Specimen retrieval was challenging when the bladder tumour was solid and over 2 cm.
背景 整块经尿道膀胱组织切除术（ETURBT）最近被提出，就膀胱癌的治疗效果而言，它是经尿道膀胱组织切除术（TURBT）的一种良好替代技术。本研究旨在评估该技术在临床、病理和肿瘤学方面的有效性。方法 在这项前瞻性研究中，收集了2021年6月至2022年6月期间因膀胱占位性病变接受ETURBT的患者的数据。记录人口统计学特征、肿瘤特征和术后结果。结果 共研究了52例患者，大多数为男性，平均年龄50.87岁。22例（38.5%）患者有吸烟史，8例（15.4%）患者接受抗血小板治疗。大多数患者属于美国麻醉医师协会（ASA）I级（59.6%）。大多数肿瘤为单发（90.4%）、原发性（82.8%）、乳头状结构（73.1%），大小在1 - 3厘米之间。侧壁是最常见的位置，98.1%的标本可见逼尿肌。常见特征为T1期（57.7%）和低级别（67.3%）。76.9%的ETURBT使用单极电灼进行。3例（5.8%）出现复发，1例（1.9%）患者发生膀胱穿孔。6例患者（11.5%）出现电灼伪像，9例患者（17.3%）出现闭孔肌反射。结论 我们的研究表明，ETURBT对于小于3厘米的膀胱肿瘤是一种成功率较高的技术。其优点包括获取逼尿肌样本的机会高，同时将挤压伪像和电灼损伤降至最低。当膀胱肿瘤为实性且超过2厘米时，标本获取具有挑战性。
