Top

Published in:

01-04-2018 | Urology - Original Paper

Transurethral en bloc resection with bipolar button electrode for non-muscle invasive bladder cancer

Authors: Junfeng Zhang, Longsheng Wang, Shiyu Mao, Mengnan Liu, Wentao Zhang, Ziwei Zhang, Yadong Guo, Bisheng Huang, Yang Yan, Yong Huang, Xudong Yao

Published in: International Urology and Nephrology | Issue 4/2018

Abstract

Purpose

Transurethral resection of bladder tumor (TURBT) using a wire loop is considered the gold standard for staging and treating non-muscle invasive bladder cancer (NMIBC). TURBT is associated with serious disadvantages that facilitate tumor recurrence. The present study evaluated the safety and efficacy of the bipolar button electrode for en bloc resection of NMIBC.

Methods

From January 2013 to July 2016, 82 consecutive patients newly diagnosed with NMIBC received transurethral en bloc resection with bipolar button electrode. Operative details, pathological result, and intraoperative and postoperative complications regarded as safety outcomes were documented. Each patient was followed up for ≥ 18 months.

Results

A total of 118 neoplasms were removed en bloc from 82 patients. The mean tumor diameter was 2.42 ± 1.34 cm. The average operation time was 35 ± 14 min. No complications such as bladder bleeding, vesicle perforation, and obturator nerve reflex occurred during the treatment. Pathological evaluations showed urothelial carcinoma with stage Ta low grade in 26 patients, T1 high grade in 51 patients, and T2 high grade in 5 patients. In addition, the bladder detrusor muscle layer was provided in all cases. The 18-month recurrence-free survival was 88.5% (23/26) and 74.5% (38/51) for Ta and T1 patients, respectively.

Conclusions

The current results demonstrated that transurethral en bloc resection with bipolar button electrode is an effective, feasible, and safe treatment for NMIBC.

Babjuk M, Oosterlinck W, Sylvester R et al (2011) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder, the 2011 update. Eur Urol 59:997–1008CrossRefPubMed

De Berardinis E, Busetto GM, Antonini G et al (2011) T1G3 high-risk NMIBC (non-muscle invasive bladder cancer): conservative treatment versus immediate cystectomy. Int Urol Nephrol 43:1047–1057CrossRefPubMed

Koie T, Ohyama C, Hosogoe S et al (2015) Oncological outcomes of a single but extensive transurethral resection followed by appropriate intra-vesical instillation therapy for newly diagnosed non-muscle-invasive bladder cancer. Int Urol Nephrol 47:1509–1514CrossRefPubMed

Guo CC, Al-Ahmadie HA, Flaig TW et al (2018) Contribution of bladder cancer pathology assessment in planning clinical trials. Urol Oncol. https://doi.org/10.1016/j.urolonc.2018.01.001

Hurle R, Lazzeri M, Colombo P et al (2016) “En bloc” resection of nonmuscle invasive bladder cancer: a prospective single-center study. Urology 90:126–130CrossRefPubMed

Mariappan P, Zachou A, Grigor KM et al (2010) Detrusor muscle in the first, apparently complete transurethral resection of bladder tumour specimen is a surrogate marker of resection quality, predicts risk of early recurrence, and is dependent on operator experience. Eur Urol 57:843–849CrossRefPubMed

Weiner AB, Keeter MK, Manjunath A et al (2018) Discrepancies in staging, treatment, and delays to treatment may explain disparities in bladder cancer outcomes: an update from the National Cancer Data Base (2004–2013). Urol Oncol. https://doi.org/10.1016/j.urolonc.2017.12.015

Xishuang S, Deyong Y, Xiangyu C et al (2010) Comparing the safety and efficiency of conventional monopolar, plasmakinetic, and holmium laser transurethral resection of primary non-muscle invasive bladder cancer. J Endourol 24:69–73CrossRefPubMed

Fritsche HM, Otto W, Eder F et al (2011) Water-jet-aided transurethral dissection of urothelial carcinoma: a prospective clinical study. J Endourol 25:1599–1603CrossRefPubMed

10.

Nagele U, Kugler M, Nicklas A et al (2011) Waterjet hydrodissection: first experiences and short-term outcomes of a novel approach to bladder tumor resection. World J Urol 29:423–427CrossRefPubMed

11.

Wolters M, Kramer MW, Becker JU et al (2011) Tm:YAG laser en bloc mucosectomy for accurate staging of primary bladder cancer: early experience. World J Urol 29:429–432CrossRefPubMed

12.

Witjes JA, Comperat E, Cowan NC et al (2014) EAU guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2013 guidelines. Eur Urol 65:778–792CrossRefPubMed

13.

Li Z, Hou R, Li J (2014) The efficacy and safety of simultaneous transurethral GreenLight photoselective vaporization of bladder tumor and prostate in patients with bladder tumor and lower urinary tract symptoms. Int Urol Nephrol 46:691–694CrossRefPubMed

14.

Kurth KH, Bouffioux C, Sylvester R et al (2000) Treatment of superficial bladder tumors: achievements and needs. The EORTC Genitourinary Group. Eur Urol 37(Suppl 3):1–9CrossRefPubMed

15.

Kramer MW, Rassweiler JJ, Klein J et al (2015) 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. World J Urol 33:1937–1943CrossRefPubMed

16.

Pavone-Macaluso M, Lopez-Beltran A, Aragona F, Bassi P et al (2006) The pathology of bladder cancer: an update on selected issues. BJU Int 98:1161–1165CrossRefPubMed

17.

Kramer MW, Altieri V, Hurle R et al (2017) Current evidence of transurethral en-bloc resection of nonmuscle invasive bladder cancer. Eur Urol Focus. https://doi.org/10.1016/j.euf.2016.12.004 PubMed

18.

Wu YP, Lin TT, Chen SH et al (2016) Comparison of the efficacy and feasibility of en bloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor: a meta-analysis. Medicine (Baltimore) 95:e5372CrossRef

19.

Ukai R, Kawashita E, Ikeda H (2000) A new technique for transurethral resection of superficial bladder tumor in 1 piece. J Urol 163:878–879CrossRefPubMed

20.

Kawada T, Ebihara K, Suzuki T et al (1997) A new technique for transurethral resection of bladder tumors: rotational tumor resection using a new arched electrode. J Urol 157:2225–2226CrossRefPubMed

21.

Saito S (2001) Transurethral en bloc resection of bladder tumors. J Urol 166:2148–2150CrossRefPubMed

22.

Zhang Z, Zeng S, Zhao J et al (2017) A pilot study of vela laser for en bloc resection of papillary bladder cancer. Clin Genitourin Cancer 15:e311–e314CrossRefPubMed

23.

Puppo P, Bertolotto F, Introini C et al (2009) Bipolar transurethral resection in saline (TURis): outcome and complication rates after the first 1000 cases. J Endourol 23:1145–1149CrossRefPubMed

24.

Reich O, Schlenker B, Gratzke C et al (2010) Plasma vaporisation of the prostate: initial clinical results. Eur Urol 57:693–697CrossRefPubMed

25.

Mashni J, Godoy G, Haarer C et al (2014) Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings. Int Urol Nephrol 46:1699–1705CrossRefPubMedPubMedCentral

26.

Geavlete B, Multescu R, Georgescu D et al (2011) Innovative technique in nonmuscle invasive bladder cancer-bipolar plasma vaporization. Urology 77:849–854CrossRefPubMed

27.

Geavlete B, Jecu M, Multescu R et al (2010) TURis plasma vaporization in non-muscle invasive bladder cancer—the first Romanian experience with a new technique. J Med Life 3:100–105PubMedPubMedCentral

28.

Canter DJ, Ogan K, Master VA (2012) Initial North American experience with the use of the Olympus Button Electrode for vaporization of bladder tumors. Can J Urol 19:6211–6216PubMed

29.

Chen X, Liao J, Chen L et al (2015) En bloc transurethral resection with 2-micron continuous-wave laser for primary non-muscle-invasive bladder cancer: a randomized controlled trial. World J Urol 33:989–995CrossRefPubMed

30.

Naselli A, Puppo P (2017) En bloc transurethral resection of bladder tumors: a new standard? J Endourol 31:S20–S24CrossRefPubMed

Title: Transurethral en bloc resection with bipolar button electrode for non-muscle invasive bladder cancer
Authors: Junfeng Zhang
Longsheng Wang
Shiyu Mao
Mengnan Liu
Wentao Zhang
Ziwei Zhang
Yadong Guo
Bisheng Huang
Yang Yan
Yong Huang
Xudong Yao
Publication date: 01-04-2018
Publisher: Springer Netherlands
Published in: International Urology and Nephrology / Issue 4/2018
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-018-1830-0

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Transurethral en bloc resection with bipolar button electrode for non-muscle invasive bladder cancer

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2018

Klotho ameliorates hydrogen peroxide-induced oxidative injury in TCMK-1 cells

Impact of low-dose steroids on HbA1c levels and development of pre-diabetes and NODAT in non-diabetic renal transplant recipients on long-term follow-up

Crosstalk between TLR4 and Notch1 signaling in the IgA nephropathy during inflammatory response

Effect of varicocele repair on sperm DNA fragmentation: a review

Collectins in urinary tract and kidney diseases

Nutritional status in short daily hemodialysis versus conventional hemodialysis patients in China

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page