En bloc resection of urothelial cancer within the urinary bladder: the upcoming gold standard?

Karl, Alexander; Herrmann, Thomas

doi:10.1007/s00345-015-1498-3

Cited by 16 publications

(5 citation statements)

References 9 publications

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“…It remains controversial whether the actual potential of ETURBT resides more in the therapeutic or diagnostic sector. [21,22] On one hand, CTURBT is dependent on in situ tumor fragmentation for tumor removal and specimen retrieval, and basic oncological surgical tenet was violated by CTURBT. This practice will promote tumor cell dispersal, and the pathological integrity of the specimen will be jeopardized.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy and feasibility of en bloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor

Lin

Chen

et al. 2016

Medicine

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Background:The aim of this meta-analysis was to compare the feasibility of en bloc transurethral resection of bladder tumor (ETURBT) versus conventional transurethral resection of bladder tumor (CTURBT).Methods:Relevant trials were identified in a literature search of MEDLINE, EMBASE, Cochrane Library, Web of Science, and Google Scholar using appropriate search terms. All comparative studies reporting participant demographics, tumor characteristics, study characteristics, and outcome data were included.Results:Seven trials with 886 participants were included, 438 underwent ETURBT and 448 underwent CTURBT. There was no significant difference in operation time between 2 groups (P = 0.38). The hospitalization time (HT) and catheterization time (CT) were shorter in ETURBT group (mean difference[MD] −1.22, 95% confidence interval [CI] −1.63 to −0.80, P < 0.01; MD −0.61, 95% CI −1.11 to −0.11, P < 0.01). There was significant difference in 24-month recurrence rate (24-month RR) (odds ratio [OR] 0.66, 95% CI 0.47–0.92, P = 0.02). The rate of complication with respect to bladder perforation (P = 0.004), bladder irritation (P < 0.01), and obturator nerve reflex (P < 0.01) was lower in ETURBT. The postoperative adjuvant intravesical chemotherapy was evaluated by subgroup analysis, and 24-month RR in CTURBT is higher than that in ETURBT in mitomycin intravesical irrigation group (P = 0.02).Conclusion:The first meta-analysis indicates that ETURBT might prove to be preferable alternative to CTURBT management of nonmuscle invasive bladder carcinoma. ETURBT is associated with shorter HT and CT, less complication rate, and lower recurrence-free rate. Moreover, it can provide high-qualified specimen for the pathologic diagnosis. Well designed randomized controlled trials are needed to make results comparable.

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Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy and feasibility of en bloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor

Lin

Chen

et al. 2016

Medicine

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“…The applicability of en bloc techniques can be limited by lesion location. Lesions on the anterior and posterior bladder walls and the dome are less favorable for ERBT [3,23,24]. Laser ERBT presents a particular challenge, as the end-firing laser cannot change direction, making it more challenging to resect lesions located on the face of the endoscope (at the dome).…”

Section: Discussionmentioning

confidence: 99%

Rotatable Bi-Channel En Bloc Resection of Bladder Tumor for Non-Muscle-Invasive Bladder Cancer in an Ex Vivo Porcine Model

Yao,

Jiang,

Niu

et al. 2023

Cancers

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En bloc resection of bladder tumor (ERBT) is a promising alternative for non-muscle-invasive bladder cancer management. However, the tumor characteristics and surgeon’s experience influence its application. Therefore, in this pilot study, we developed a technique called “rotatable bi-channel en bloc resection of bladder tumor (RBC-ERBT)” and assessed its feasibility, efficacy, and safety compared with those of conventional ERBT. In an ex vivo porcine bladder model, 160 bladder lesions of varying morphologies (exophytic and flat) and sizes (1 and 2 cm) were created and evenly distributed across different locations. A total of 160 procedures were performed, with the ERBT and RBC-ERBT group each exhibiting 80 lesions. RBC-ERBT had a significantly higher technical success rate than ERBT (98.8% vs. 77.5%) for exophytic and flat lesions of both sizes and dome lesions. The procedure time was significantly shorter in the RBC-ERBT group, particularly for flat lesions, lesions with a 2 cm diameter, and lesions located at the dome. RBC-ERBT had a significantly lower piecemeal resection rate than ERBT (0% vs. 18.8%). The incidence of perforation or detrusor muscle sampling did not differ between the groups. Compared with conventional ERBT, RBC-ERBT offered improved success rates, reduced resection times, and effective management of challenging lesions.

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“…Alle Publikationen der letzten Jahre zeigen, dass die transurethrale ERBT das Potenzial hat, die endoskopische Diagnostik und Therapie des NMIBC zu verändern [25,26]. Neben der Auswahl der Energiequelle stehen dem Anwender grundsätzlich zwei Prinzipien zur Verfügung.…”

Section: En Bloc-resektionstechnikenunclassified

“…Perforationen sollen so vermieden werden. Aktuell ist die ERBT "plus" nur mit dem monopolaren Hybridknife der Firma ERBE aus Tübingen möglich [25,27].…”

Section: En Bloc-resektionstechnikenunclassified

Die En bloc-Resektion von Blasentumoren (ERBT) – eine Bestandsaufnahme

et al. 2017

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Limitations inherent in the conventional transurethral resection of bladder tumours, the standard approach for diagnosis and treatment of bladder cancer, are well known: staging errors due to insufficient resection depth as well as intravesical tumour fragmentation, both of which make histopathological evaluation difficult. The purpose of this review is to present recent clinical data on the en-bloc resection of bladder tumours (ERBT), which has been demonstrated to offer a high potential to overcome these limitations. The recent findings show that ERBT provides a good resection quality with varying detection rates for tunica muscularis, which is a surrogate marker for resection quality regarding muscle-invasive tumours. ERBT can be performed using all energy sources. Available data show no relevant difference with regard to perioperative morbidity compared with cTURB. No conclusions can be drawn regarding the impact of ERBT on recurrence as the data are partly controversial. This has to be defined by further studies.

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En bloc resection of urothelial cancer within the urinary bladder: the upcoming gold standard?

Cited by 16 publications

References 9 publications

Comparison of the efficacy and feasibility of en bloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor

Comparison of the efficacy and feasibility of en bloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor

Rotatable Bi-Channel En Bloc Resection of Bladder Tumor for Non-Muscle-Invasive Bladder Cancer in an Ex Vivo Porcine Model

Die En bloc-Resektion von Blasentumoren (ERBT) – eine Bestandsaufnahme

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