En bloc resection of urothelium carcinoma of the bladder (EBRUC): a European multicenter study to compare safety, efficacy, and outcome of laser and electrical en bloc transurethral resection of bladder tumor

Kramer, Mario W.; Rassweiler, Jens; Klein, Jan; Martov, A G; Baykov, Nikolay; Lusuardi, Lukas; Janetschek, Günter; Hurle, Rodolfo; Wolters, M.; Abbas, Mahmoud; Klot, Christoph A. von; Leitenberger, A.; Riedl, Markus; Nagele, Udo; Merseburger, Axel S.; Kuczyk, Markus A.; Babjuk, Marko; Herrmann, Thomas

doi:10.1007/s00345-015-1568-6

Cited by 138 publications

(128 citation statements)

References 28 publications

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“…The tumor cutoff size was comparable with other studies. [91011] ONR and bladder perforation rate were significantly lower in the HoL-EBRBT group than the CM-TURBT group. In fact, no ONR was observed in the HoL-EBRBT group.…”

Section: Discussionmentioning

confidence: 78%

“…However, now holmium laser can ensure en bloc resection of the bladder tumor, and provide enough tissue for histologic examination. [91011] Holmium laser has a wavelength of 2100 nm, and a short extinction length due to the strong absorption by water molecules. At this wavelength, the tissue penetration depth of the laser is about 400 µm, which is reasonably safe.…”

Section: Discussionmentioning

confidence: 99%

“…Holmium laser generates steam bubbles in the irrigant at the fiber tip, separating the tissue layers by tearing them apart and simultaneously coagulating small- and middle-sized vessels to a depth of 2–3 mm, showing rapid tissue effect as well as excellent hemostasis. [9101112131415] Holmium laser vaporization, though less invasive, will not provide tissue for histopathological evaluation.…”

Section: Discussionmentioning

confidence: 99%

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Holmium laser transurethral resection of bladder tumor: Our experience

Dsouza

Verma

2016

Urol Ann

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Purpose:To compare the safety and efficiency of conventional monopolar and holmium laser en bloc transurethral resection of bladder tumor (CM-TURBT and HoL-EBRBT) while managing primary nonmuscle-invasive bladder cancer.Materials and Methods:From January 2012 to October 2015, fifty patients with primary nonmuscle-invasive bladder cancer underwent endoscopic surgery. Among them, 27 patients underwent CM-TURBT and 23 patients underwent HoL-EBRBT. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded.Results:Patient demographics and tumor characteristics in both groups were compared before surgery. There was no significant difference in operative duration among the groups. Compared with the CM-TURBT group, HoL-EBRBT group had less intraoperative and postoperative complications, including obturator nerve reflex (P < 0.01), bladder perforation (P < 0.01), as well as bleeding and postoperative bladder irritation (P < 0.01). There were no significant differences among the two groups in the transfusion rate and occurrence of urethral strictures. Patients in the HoL-EBRBT group had less catheterization and hospitalization time than those in the CM-TURBT group (P < 0.01), and there were no significant differences in each risk subgroup as well as the overall recurrence rate among the CM-TURBT and HoL-EBRBT groups.Conclusions:HoL-EBRBT might prove to be preferable alternatives to CM-TURBT management of nonmuscle-invasive bladder cancer. HoL-EBRBT however did not demonstrate an obvious advantage over CM-TURBT in tumor recurrence rate.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Holmium laser transurethral resection of bladder tumor: Our experience

Dsouza

Verma

2016

Urol Ann

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“…[23] Unfortunately, the trials enrolled in our study had not provided sufficient information about the data of detrusor muscle-positive specimens. To the best of our knowledge, detrusor muscle-positive specimens in 78% and 100% were reported in 2 small case series, [24,25] and the presence of the detrusor muscle layer in 97.3% of 221 samples was demonstrated by Kramer et al [26] All of enrolled trials possessed the view that ETURBT can obtain adequate complete tumor specimens, containing the mucosa, lamina propria, and muscle layer for determining pathological diagnosis and treatment procedure. [12] …”

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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“…For this reason, ERBT was recently identified as a promising TUR technique at the meeting of the European Association of Urology (EAU) section of Uro-Technology and the section of Uro-Oncology [11]. …”

Section: Discussionmentioning

confidence: 99%

A novel transurethral resection technique for superficial bladder tumor: retrograde en bloc resection

Zhang

Xing

et al. 2017

World J Surg Onc

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BackgroundTransurethral resection of bladder tumor (TURBT) is the standard approach to bladder tumors but suffers from several disadvantages. The aim of this study was to evaluate the safety and efficacy of a novel procedure of retrograde en bloc resection of bladder tumor (RERBT) with conventional monopolar resection electrode for the treatment of superficial bladder tumors.MethodsRERBT and conventional TURBT (C-TURBT) were conducted, respectively, in 40 and 50 patients diagnosed with superficial papillary bladder tumors. In the RERBT group, the tumors were en bloc removed retrogradely under direct vision using a conventional monopolar electrode. Patients’ clinicopathological, intraoperative, and postoperative data were compared retrospectively between the RERBT and C-TURBT groups.ResultsOf the 90 patients, 40 underwent RERBT and 50 underwent C-TURBT. Both groups were comparable in clinicopathological characteristic. RERBT could be performed as safely and effectively as C-TURBT. There were no significant differences in operative time and surgical complications. The cumulative recurrence rates between groups were similar during up to 18 months follow-up. The detrusor muscle could be identified pathologically in 100% of RERBT tumor specimens and the biopsy of tumor bases, but only in 54 and 70%, respectively, of C-TURBT samples (P < 0.01).ConclusionsThe RERBT technique is feasible and safe for superficial bladder tumors using conventional monopolar resection setting, with the advantages of adequate tumor resection and the ability to collect good quality tumor specimens for pathological diagnosis and staging compared to conventional TURBT.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-017-1192-6) contains supplementary material, which is available to authorized users.

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En bloc resection of urothelium carcinoma of the bladder (EBRUC): a European multicenter study to compare safety, efficacy, and outcome of laser and electrical en bloc transurethral resection of bladder tumor

Abstract: ERBT is safe and reliable regardless of the energy source and provides high-quality resections of tumors >1 cm. Recurrence rates did not differ between groups, and the majority of recurrences occurred outside the ERBT resection field.

Cited by 138 publications

References 28 publications

Holmium laser transurethral resection of bladder tumor: Our experience

Holmium laser transurethral resection of bladder tumor: Our experience

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

A novel transurethral resection technique for superficial bladder tumor: retrograde en bloc resection

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