Extravesical transitional cell carcinoma as a result of implantation after perforation of the bladder

Chakravarti, Aniruddha; Day, David W.; MacDermott, Seamus

doi:10.1046/j.1464-410x.2000.00684.x

Cited by 20 publications

(6 citation statements)

References 3 publications

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“…Interestingly, Skolarikos et al [4] mentioned open surgical repair following IPP and tumor size as risk factors for extravesical recurrence. All patients with extravesical tumor recurrences or evidence of metastatic disease had previously undergone open surgical repair [30, 31]. The authors stated that this might be due to an increased amount of tumor cell spillage during open surgery.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the Treatment of Intraperitoneal Bladder Perforation during Transurethral Resection of Bladder Tumor with the Urethral Catheter Alone: Retrospective Analysis of over 15 Years Using the Clinical Data Warehouse System

et al. 2021

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Introduction: We investigated the efficacy of a urethral catheter alone for intraperitoneal perforation during transurethral resection of bladder tumor (TURBT). Patients and Methods: We retrospectively evaluated the medical records of 4,543 patients who underwent TURBT from January 2000 to December 2017 using the Clinical Data Warehouse system. The clinicopathologic characteristics, recurrence-free survival, and progression-free survival were compared between the patient groups with intraperitoneal perforation treated with the Foley catheter alone, extraperitoneal perforation, and matched control TURBT. Results: Intraperitoneal perforation and extraperitoneal perforation were observed in 16 (35.6%) and 29 (64.4%) patients, respectively. In the intraperitoneal perforation group, 11 (68.8%), 2 (12.5%), and 3 (18.8%) patients were treated with the Foley catheter alone, additional percutaneous drainage, and delayed open surgery, respectively. The use of the Foley catheter alone in patients with intraperitoneal perforation of smaller size than the cystoscope or no pelvic radiotherapy history showed improved efficacy without sequelae or therapeutic delay. One of the 2 patients with the size of the intraperitoneal perforation larger than the cystoscope was successfully treated with the Foley catheter alone, whereas the other patient underwent delayed surgical repair. There was no difference in recurrence-free survival and progression-free survival of the intraperitoneal perforation treated with the Foley catheter alone compared to those of the matched control TURBT (p = 0.909, p = 0.518) and the extraperitoneal perforation (p = 0.458, p = 0.699). Conclusions: Intraperitoneal perforation rarely occurred during TURBT. In the case of intraperitoneal perforation of size smaller than cystoscopy or without pelvic radiotherapy history, treatment with the Foley alone showed successful improvement and safe oncological results. Therefore, treatment with the urethral catheter alone can be carefully considered when an intraperitoneal perforation smaller than the cystoscope size or without pelvic radiotherapy history occurs.

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Section: Discussionmentioning

confidence: 99%

Efficacy of the Treatment of Intraperitoneal Bladder Perforation during Transurethral Resection of Bladder Tumor with the Urethral Catheter Alone: Retrospective Analysis of over 15 Years Using the Clinical Data Warehouse System

et al. 2021

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“…Recurrent TCC, presumably from tumor spillage during TURBT or after RC, or from circulating tumor cells, has been reported in abdominal wounds, suprapubic tube sites, in the pelvic cavity (resection bed), and on the psoas muscle [15][16][17][18] . The use of prophylactic radiation or systemic chemotherapy in the setting of TCC spillage remains unclear with significant potential morbidity.…”

Section: Discussionmentioning

confidence: 99%

Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

et al. 2017

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“…Reports addressing the oncological outcomes of bladder perforation during TURBT have generally yielded inconclusive evidence [1,2,[6][7][8][9][10] (Table 2). Traditionally, seeding of transitional carcinoma outside the urinary tract has been recognized after open surgical procedures such as partial cystectomy or suprapubic cystotomy [11].…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, seeding of transitional carcinoma outside the urinary tract has been recognized after open surgical procedures such as partial cystectomy or suprapubic cystotomy [11]. Although some case reports and small case series indicated that open repair of a bladder perforation during TURBT may predispose patients to a similar risk [8,9], others failed to do so [1,2,6,7]. Skolarikos et al .…”

Section: Discussionmentioning

confidence: 99%

Transurethral resection of bladder tumour complicated by perforation requiring open surgical repair – clinical characteristics and oncological outcomes

et al. 2010

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Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Evidence suggests that open repair of a bladder perforation during TURBT may increase the risk of pelvic or distant disease recurrence. The study demonstrates that while bladder violation during TURBT may carry a potential for considerable morbidity, it does not seem to substantially increase the risk of extravesical tumour seeding and disease recurrence. OBJECTIVE • To examine the clinical characteristics and long‐term outcomes of patients with bladder perforation requiring open surgical repair as a complication of transurethral resection of bladder tumour (TURBT). PATIENT AND METHODS • A search of our institutional database yielded 4144 patients who underwent TURBT from 1996 to 2008, of whom 15 (0.36%) required open surgical intervention to repair a large bladder perforation. • In all cases, a filling cystogram was performed before laparotomy. Clinical, pathological and follow‐up data were reviewed, and the incidence and time of extravesical tumour recurrence were recorded. RESULTS • Median patient age was 77 years. Intraperitoneal perforation was diagnosed in 12 patients, generally involving the posterior wall. Concomitant bowel injury was identified in two patients and managed by primary repair. Two patients in whom the diagnosis and intervention were delayed died within 1 week of surgery. • Metastatic progression was observed in two patients shortly after the perforation (median interval, 4.8 months), and local pelvic recurrence was noted in one of them. • None of the patients with stage Ta tumours had evidence of extravesical progression. Actuarial estimates of disease‐free survival at 1, 3 and 5 years after the perforation were 83%, 71% and 41%, respectively. CONCLUSIONS • A significant bladder perforation during TURBT requiring open surgical repair is more likely to occur in elderly patients with large posterior wall tumours and heavily pretreated bladders. • Despite its potential for considerable morbidity, this adverse event does not seem to substantially increase the risk of extravesical tumour seeding. Prompt diagnosis, immediate intervention and meticulous bladder and bowel inspection during laparotomy are imperative.

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Extravesical transitional cell carcinoma as a result of implantation after perforation of the bladder

Cited by 20 publications

References 3 publications

Efficacy of the Treatment of Intraperitoneal Bladder Perforation during Transurethral Resection of Bladder Tumor with the Urethral Catheter Alone: Retrospective Analysis of over 15 Years Using the Clinical Data Warehouse System

Efficacy of the Treatment of Intraperitoneal Bladder Perforation during Transurethral Resection of Bladder Tumor with the Urethral Catheter Alone: Retrospective Analysis of over 15 Years Using the Clinical Data Warehouse System

Early Oncologic Failure after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium

Transurethral resection of bladder tumour complicated by perforation requiring open surgical repair – clinical characteristics and oncological outcomes

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