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En-bloc resection for primary non-muscle invasive bladder cancer: Our initial experience

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En-bloc resection for primary non-muscle invasive bladder cancer: our initial experience

EIML Liem, GM Kamphuis, J Baard, JE Freund, MP Laguna Pes, DM de Bruin, JJMCH de la Rosette, TM de Reijke

Academic Medical Center, Amsterdam, The Netherlands

 

Introduction & objective

High quality transurethral resection of bladder tumours (TURB) are crucial for bladder cancer diagnosis and treatment. Conventional TURB (cTURB) goes against the basic principle of oncologic surgery; tumours should be resected as a whole to reduce tumour spill. Also tumour fragmentation leads to loss of orientation and impedes optimal staging.

Objective: to evaluate our initial experience of en-bloc resection for treatment of non-muscle invasive bladder cancer (NMIBC)

 

Methods

Population: Patients with primary bladder tumour treated with en-bloc resection matched to patients treated with cTURB based on focality, tumour size and adjuvant instillations

Outcomes of interest: intra- and postoperative complications, presence detrusor muscle in resected specimen, residual/recurrent tumour evaluation (3 months)

 

  En-bloc resection 

    The bladder mucosa is incised around the tumour

    The tumour is undermined, using resection loop or Collings knife

    After en-bloc resection the tumour is evacuated in one piece

 

Conclusion

•   En-bloc resection seems a safe technique to treat patients with NMIBC

•   En-bloc resection could possibly improve staging of bladder tumours,   due to the presence of detrusor muscle and preservation of orientation

 

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