En-bloc laser resection of the urinary bladder tumor


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Currently, transurethral resection of a bladder tumor (TUR) is the gold standart treatment for non-muscle invasive bladder cancer (NMIBC). Standard TUR for a bladder wall tumor has a high recurrence rate, which is caused mainly by malignant cell implantation during the surgery. Besides, specimens obtained with conventional TUR are insufficient for accurate pathological staging. The nonconformity of the standard TUR with the established oncological principle of dissecting through normal tissue prompted a search for the optimal surgical modality. En-bloc resection of the bladder wall tumor has been proposed as an alternative method for surgical management of NMIBC. This technique involves the resection of bladder tumor through the underlying muscle layer as a single piece thus providing high quality material for subsequent morphological study and reducing the risk of metastasizing by implantation of malignant cells. This paper presents an analysis of relevant research literature published in the last twenty years, describes all currently existing techniques of the bladder tumor resection using a variety of energy sources, including laser.

Full Text

Restricted Access

About the authors

Yu. G Alyaev

Research Institute for Uronephrology and Human Reproductive Health, Department and Clinic of Urology, I.M. Sechenov First MSMU

Email: ugalyaev@mail.ru
Corr.-Member of the RAS, Dr.Med.Sci., Prof., Head of the Department of Urology

L. M Rapoport

Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First MSMU (Sechenov University)

Email: leonidrapoport@yandex.ru
Dr.Med.Sci., Professor at the Department of Urology, Sechenov University, Deputy Director for Clinical Care

A. Z Vinarov

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Dr.Med.Sci., Professor at the Department of Urology

N. I Sorokin

I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University)

Head of the Department of Urologic Oncology, UCH No. 2

A. M Dymov

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: alimdv@mail.ru
Ph.D., Physician at the Department ofUrologic Oncology, Clinic of Urology

D. A Kislyakov

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: dakislyakov@gmail.com
Ph.D. Student at the Research Institute for Uronephrology and Human Reproductive Health

E. V Afanasyevskaya

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: e.afanasyevskaya@mail.ru
student at the I.M. Sechenov First MSMU, laboratory assistant at the Laboratory of Regeneration of Skeletal Tissues, Institute for Regenerative Medicine

V. Yu Lekarev

I.M. Sechenov First MSMU (Sechenov University) of Minzdrav of Russia

Email: lekarev_bat@mail.ru
Ph.D. Student at the Research Institute for Uronephrology and Human Reproductive Health

References

  1. Состояние онкологической помощи населению России в 2016 году. Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена - филиал ФГБУ НМИРЦ Минздрава России. 2017;236 с. ISBN 978-5-85502-231-5
  2. Woldu S.L., Bagrodia A., Lotan Y. Guideline of guidelines: non-muscle-invasive bladder cancer. BJU Int. 2017;119(3):371-380. doi: 10.1111/bju.13760.
  3. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder. Update 2016.
  4. Qie Y., Hu H., Tian D., Zhang Y., Xie L., Xu Y., Wu C. The value of extensive transurethral resection in the diagnosis and treatment of nonmuscle invasive bladder cancer with respect to recurrence at the first follow-up cystoscopy. Onco Targets Ther. 2016;9:2019-2025. doi: 10.2147/0TT.S103703.
  5. Zainfeld D., Daneshmand S. Transurethral Resection of Bladder Tumors: Improving Quality Through New Techniques and Technologies. Curr Urol Rep. 2017;18(5):34. doi: 10.1007/s11934-017-0680-0.
  6. Sureka S.K., Agarwal V., Agnihotri S., Kapoor R., Srivastava A., Mandhani A. Is en-bloc transurethral resection of bladder tumor for non-muscle invasive bladder carcinoma better than conventional technique in terms of recurrence and progression?: A prospective study. Indian Journal of Urology : IJU : Journal of the Urological Society of India. 2014;30(2):144- 149. doi: 10.4103/0970-1591.126887.
  7. Lazica D.A., Roth S., Brandt A.S., Bottcher S., Mathers M.J., Ubrig B. Second Transurethral Resection after Ta High-Grade Bladder Tumor: A 4.5-Year Period at a Single University Center. Urol Int. 2014;92:131-135. doi: 10.1159/000353089.
  8. Uhlig A., Strauss A., Seif Amir Hosseini A., Lotz J., Trojan L., Schmid M., Uhlig J. Gender-specific Differences in Recurrence of Non-muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis. Eur Urol Focus. 2017 Sep 6. doi: 10.1016/j.euf.2017.08.007.
  9. Malmstrom P.U., Agrawal S., Blâckberg M., Bostrom P.J., Malavaud B., Zaak D., Hermann G.G. Non-muscle-invasive bladder cancer: a vision for the future Scand J. Urol. 2017;51(2):87-94. doi: 10.1080/21681805.2017.1283359.
  10. Мартов А.Г., Ергаков Д.В., Андронов А.С. Рецидивирование мышечно-неинвазивного рака мочевого пузыря: возможные эндоскопические пути решения проблемы. Онкоурология 2010;6(1):6-13. doi: 10.17650/1726-9776-2010-6-1-6-13
  11. Mariappan P., Zachou A., Grigor K.M. 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. 2010;57(5):843-849. doi: 10.1016/j.eururo.2009.05.047.
  12. Herr H.W., Donat S.M. Quality control in transurethral resection of bladder tumours. BJU Int. 2008;102(9 Pt B):1242-1246. doi: 10.1111/j.1464-410X.2008.07966.x.
  13. Liem E.I., de Reijke T.M. Can we improve transurethral resection of the bladder tumour for nonmuscle invasive bladder cancer? Curr Opin Urol. 2017;27(2):149-155. doi: 10.1097/M0U.0000000000000370.
  14. Upadhyay R., Kapoor R., Srivastava A., Krishnani N., Mandhani A. Does En-bloc transurethral resection of bladder tumor give a better yield in terms of presence of detrusor muscle in the biopsy specimen? Indian J. Urol. 2012;28(3):275-279. doi: 10.4103/0970-1591.102700.
  15. Saito S. Transurethral en bloc resection of bladder tumors, saito, seiichi. The Journal of Urology. 2001;166(6):2148-2150.
  16. Ukai R., Kawashita E., Ikeda H. A new technique for transurethral resection of superficial bladder tumor in 1 piece. J. Urol. 2000;163(3):878-879.
  17. Kawada T., Ebihara K., Suzuki T., Imai K., Yamanaka H. A new technique for transurethral resection of bladder tumors: rotational tumor resection using a new arched electrode. J. Urol. 1997;157(6):2225-2226.
  18. Balci M., Tuncel A., Keten T., Guzel O., Lokman U., Koseoglu E., Aslan Y., Atan A. Comparison of Monopolar and Bipolar Transurethral Resection of Non-Muscle Invasive Bladder Cancer. Urol Int. 2018;100(1):100-104.
  19. Bolat D., Gunlusoy B., Degirmenci T., Ceylan Y., Polat S., Aydin E., Aydogdu O., Kozacioglu Z. Comparing the short-term outcomes and complications of monopolar and bipolar transurethral resection of non-muscle invasive bladder cancers: A prospective, randomized, controlled study. Arch Esp Urol. 2016;69(5):225-233.
  20. Yang S.J., Song P.H., Kim H.T. Comparison of Deep Biopsy Tissue Damage from Transurethral Resection of Bladder Tumors between Bipolar and Monopolar Devices. Korean Journal of Urology. 2011 ;52(6):379-383. doi: 10.4111/kju.2011.52.6.379.
  21. Babjuk M. Transurethral Resection of Non-muscle-invasive Bladder Cancer. Eur Urol. Supplements. 8(7):542-548.
  22. Nieder A.M., Meinbach D.S., Kim S.S., Soloway M.S. Transurethral bladder tumor resection: Intraoperative and postoperative complications in a residency setting. J. Urol. 2005;174:2307-2379.
  23. Guo N., Su D. Incidence and Prediction of Catheter-related Bladder Discomfort after Transurethral Bladder Tumor Resection. West Indian Medical Journal. doi: 10.7727/wimj.2015.601.
  24. Gregg J.R., McCormick B., Wang L., Cohen P., Sun D., Penson D.F., Smith J.A., Clark P.E., Cookson M.S., Barocas D.A., Resnick M.J., Moses K.A., Chang S.S. Short term complications from transurethral resection of bladder tumor. Can J. Urol. 2016;23(2):8198-81203.
  25. Engilbertsson H., Aaltonen K.E., Bjornsson S., Kristmundsson T., Patschan O., Rydén L., Gudjonsson S. Transurethral bladder tumor resection can cause seeding of cancer cells into the bloodstream. J. Urol. 2015;193(1):53-57. doi: 10.1016/j.juro.2014.06.083.
  26. Shah N.F., Sofi K.P., Nengroo S.H. Obturator Nerve Block in Transurethral Resection of Bladder Tumor: A Comparison of Ultrasound-guided Technique versus Ultrasound with Nerve Stimulation Technique. Anesth Essays Res. 2017;11(2):411-415. doi: 10.4103/0259-1162.194580.
  27. Bolat D., Aydogdu O., Tekgul Z.T., Polat S., Yonguc T., Bozkurt I.H., Sen V., Okur O. Impact of nerve stimulator-guided obturator nerve block on the short-term outcomes and complications of transurethral resection of bladder tumour: A prospective randomized controlled study. Can Urol Assoc J. 2015;9(11-12):E780-784. doi: 10.5489/cuaj.3149.
  28. Wilby D., Thomas K., Ray E., Chappell B., O’Brien T. Bladder cancer: new TUR techniques. World J. Urol. 2009;27(3):309-312. doi: 10.1007/s00345-009-0398-9.
  29. Lodde M., Lusuardi L., Palermo S., Signorello D., Maier K., Hohenfellner R., Pycha A. En bloc transurethral resection of bladder tumors: use and limits. Urology. 2003;62(6):1089-1091.
  30. Мартов А.Г., Ергаков Д.В., Байков Н.А. Трансуретральная гольмиевая резекция мочевого пузыря с применением техники единого блока. Медицинский вестник Башкортостана. 2015;10(3)
  31. Naselli A., Introini C., Germinale F., Spina B., Puppo P. Surgery illustrated - Focus on details en bloc transurethral resection of bladder lesions: A trick to retrieve specimens up to 4.5 cm. BJU Int. 2012;109(6):960-963. doi: 10.1111/j.1464-410X.2012.10982.x.
  32. Kramer M.W., Rassweiler J.J., Klein J., Martov A., Baykov N., Lusuardi L., Janetschek G., Hurle R., Wolters M., Abbas M., von Klot C.A., Leitenberger A., Riedl M., Nagele U., Merseburger A.S., Kuczyk M.A.,Babjuk M., Herrmann T.R. 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. 2015;33(12):1937-1943. doi: 10.1007/s00345-015-1568-6.
  33. Tan W.S., Rodney S., Lamb B., Feneley M., Kelly J. Management of nonmuscle invasive bladder cancer: A comprehensive analysis of guidelines from the United States, Europe and Asia. Cancer Treat Rev. 2016;47:22- 31. doi: 10.1016/j.ctrv.2016.05.002.
  34. Ukai R., Hashimoto K., Iwasa T., Nakayama H. Transurethral resection in one piece (TURBO) is an accurate tool for pathological staging of bladder tumor. Int J. Urol. 2010;17(8):708-14. doi: 10.1111/j.1442-2042.2010.02571.x.
  35. Maurice M.J., Vricella G.J., MacLennan G., Buehner P., Ponsky L.E. Endoscopic snare resection of bladder tumors: evaluation of an alternative technique for bladder tumor resection. J. Endourol. 2012;26(6):614-617. doi: 10.1089/end.2011.0587.
  36. Naselli A., Puppo P. En Bloc Transurethral Resection of Bladder Tumors: A New Standard? J. Endourol. 2017;31(S1):20-24. doi: 10.1089/end.2016.0534.
  37. Kramer M.W., Wolters M., Herrmann T.R. En Bloc Resection of Bladder Tumors: Ready for Prime Time? Eur Urol. 2016;69(5):967-968. doi: 10.1016/j.eururo.2016.01.004.
  38. D’Souza N., Verma A. Holmium laser transurethral resection of bladder tumor: Our experience. Urol Ann. 2016;8(4):439-443. doi: 10.4103/09747796.190815.
  39. Nagele U., Kugler M., Nicklas A., Merseburger A.S., Walcher U., Mikuz G., Herrmann T.R. Wateijet hydrodissection: first experiences and short-term outcomes of a novel approach to bladder tumor resection. World J. Urol. 2011;29(4):423-427. doi: 10.1007/s00345-011-0653-8.
  40. Resektion von Blasentumoren mit dem HybridKnife unter Verwendung des Fluoreszenzmarkers Hexvix. DRKS-ID der Studie: DRKS00004414.
  41. Morizane S., Sejima T., Iwamoto H., Masago T., Honda M., Ikebuchi Y., Matsumoto K., Ueki M., Takenaka A. Transurethral En Bloc Resection of Bladder Tumor Using an Endoscopic Submucosal Dissection Technique: Preliminary Results in an Animal Model. Yonago Acta Med. 2016;59(2):143-148.
  42. Migliari R., Buffardi A., Ghabin H. Thulium Laser Endoscopic En Bloc Enucleation of Nonmuscle-Invasive Bladder Cancer. J. Endourol. 2015;29(11):1258-1262. doi: 10.1089/end.2015.0336.
  43. Zhang Z., Zeng S., Zhao J., Lu X., Xu W., Ma C., Wang Y., Chen X., Jia G., Zhou T., Sun Y., Xu C. A pilot study of Vela laser for en bloc resection of papillary bladder cancer. Clin Genitourin Cancer. 2017;15(3):311-314. doi: 10.1016/j.clgc.2016.06.004.
  44. Zhang K.Y., Xing J.C., Li W., Wu Z., Chen B., Bai D.Y. A novel transurethral resection technique for superficial bladder tumor: retrograde en bloc resection. World J. Surg Oncol. 2017;15(1):125. doi: 10.1186/s12957-017-1192-6.
  45. Gontero P., Sylvester R., Pisano F., Joniau S., Oderda M., Serretta V., Larré S., DiStasi S., Van Rhijn B., Witjes A.J., Grotenhuis A.J., Colombo R., Briganti A., Babjuk M., Soukup V., Malmstrom P.U., Irani J., Malats N., Baniel J., Mano R., Cai T., Cha E.K., Ardelt P., Vakarakis J., Bartoletti R., Dalbagni G., Shariat S.F., Xylinas E., Karnes R.J., Palou J. The impact of re-transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 highgrade/Grade 3 bladder cancer treated with bacille Calmette-Guérin. BJU Int. 2016;118(1):44- 52. doi: 10.1111/bju.13354.
  46. Patschan O., Holmâng S., Hosseini A., Jancke G., Liedberg F., Ljungberg B., Malmstrom P.U., Rosell J., Jahnson S. Second-look resection for primary stage T1 bladder cancer: a population-based study. Scand J. Urol. 2017;51(4):301-307. doi: 10.1080/21681805.2017.1303846.
  47. Hurle R., Lazzeri M., Colombo P., Buffi N., Morenghi E., Peschechera R., Castaldo L., Pasini L., Casale P., Seveso M., Zandegiacomo S., Taverna G., Benetti A., Lughezzani G., Fiorini G., Guazzoni G. «En Bloc» Resection of Nonmuscle Invasive Bladder Cancer: A Prospective Single-center Study. Urology. 2016;90:126-130. doi: 10.1016/j.urology.2016.01.004.
  48. Hafner C., Knuechel R., Zanardo L., Dietmaier W., Blaszyk H., Cheville J., Hofstaedter F., Hartmann A. Evidence for oligoclonality and tumour spread by intraluminal seeding in multifocal urothelial carcinomas of the upper and lower urinary tract. Oncogene. 2001;20(35):4910-4915.
  49. Huncharek M., McGarry R., Kupelnick B. Impact of intravesical chemotherapy on recurrence rate of recurrent superficial transitional cell carcinoma of the bladder: results of a meta-analysis. Anticancer Res. 2001;21(1B):765-769.
  50. Sylvester R.J., Oosterlinck W., van der Meijden A.P. A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J. Urol. 2004;171(6 Pt 1):2186-2190.
  51. Sylvester R.J., Oosterlinck W., Holmang S., Sydes M.R., Birtle A., Gudjonsson S., DeNunzio C., Okamura K., Kaasinen E., Solsona E., Ali-El-Dein B., Tatar C.A., Inman B.A., N’Dow J., Oddens J.R., Babjuk M. Systematic Review and Individual Patient Data Meta-analysis of Randomized Trials Comparing a Single Immediate Instillation of Chemotherapy After Transurethral Resection with Transurethral Resection Alone in Patients with Stage pTa-pT1 Urothelial Carcinoma of the Bladder: Which Patients Benefit from the Instillation? Eur Urol. 2016;69(2):231-244. Doi: 10.1016/j. eururo.2015.05.050.
  52. Yang H., Wang N., Han S., Male M., Zhao C., Yao D., Chen Z. Comparison of the efficacy and feasibility of laser enucleation of bladder tumor versus transurethral resection of bladder tumor: a meta-analysis. Lasers Med Sci. 2017;32(9):2005-2012. doi: 10.1007/s10103-017-2308-5.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2018 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies