Khattak Muhammad Ali, Bangash Muhibullah, Aziz Wajahat, Ghaffar Sara, Asghar Ayesha, Iqbal Yasir, Abdulrasheed Habeeb, Khan Awais Nawaz, Khan Asad Ali
Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR.
Urology, Aga Khan University Hospital, Karachi, PAK.
Cureus. 2024 Aug 29;16(8):e68143. doi: 10.7759/cureus.68143. eCollection 2024 Aug.
This study aimed to assess the quality of primary transurethral resection of bladder tumor (TURBT) procedures performed at Aga Khan University Hospital (AKUH) over nine years, focusing on proper documentation, completeness of tumor resection, quality of histopathology reports, complication rates, and adherence to European Association of Urology (EAU) guidelines.
A retrospective analysis of patients aged 25-75 who underwent primary TURBT at AKUH between 2010 and 2019 was done. Patients with incomplete records, concomitant procedures, or those who underwent emergency TURBT were excluded. Data was collected on patient demographics, clinical presentation, intraoperative details, and histopathology reports. Statistical analysis was performed using SPSS Version 27.0.
300 patients were initially identified, with 265 meeting the inclusion criteria. The mean age was 61.5 years, with 83% being male. Complete tumor resection was achieved in 35% (n=92) of cases, while deep biopsy was taken in 85% (n=226). Detrusor muscle (DM), a marker of resection quality, was noted in 75% (n=200) of histopathology reports. However, documentation quality varied, with 54% (n=143) of cases lacking clear information on resection completeness. The administration of a single instillation of a chemotherapeutic agent (SICA) was recorded in 79% (n=210) of patients, and the 30-day postoperative complication rate was monitored.
The study highlights areas for improvement in the quality of TURBT procedures at AKUH, particularly in the documentation of resection completeness and adherence to established guidelines. Ensuring thorough resection and proper documentation is critical to optimizing patient outcomes and future management plans.
本研究旨在评估阿迦汗大学医院(AKUH)在九年期间进行的原发性经尿道膀胱肿瘤切除术(TURBT)的手术质量,重点关注恰当的记录、肿瘤切除的完整性、组织病理学报告的质量、并发症发生率以及对欧洲泌尿外科学会(EAU)指南的遵循情况。
对2010年至2019年期间在AKUH接受原发性TURBT的25至75岁患者进行回顾性分析。排除记录不完整、同时进行其他手术或接受急诊TURBT的患者。收集患者的人口统计学资料、临床表现、术中细节和组织病理学报告。使用SPSS 27.0进行统计分析。
最初确定了300例患者,其中265例符合纳入标准。平均年龄为61.5岁,男性占83%。35%(n = 92)的病例实现了肿瘤完全切除,85%(n = 226)的病例进行了深度活检。75%(n = 200)的组织病理学报告中提到了作为切除质量标志物的逼尿肌(DM)。然而,记录质量参差不齐,54%(n = 143)的病例缺乏关于切除完整性的明确信息。79%(n = 210)的患者记录了单次化疗药物灌注(SICA),并监测了术后30天的并发症发生率。
该研究突出了AKUH在TURBT手术质量方面需要改进的领域,特别是在切除完整性的记录和遵循既定指南方面。确保彻底切除和恰当记录对于优化患者预后和未来管理计划至关重要。