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

Int Urol Nephrol. 2018 Apr;50(4):619-623. doi: 10.1007/s11255-018-1830-0. Epub 2018 Feb 24.

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.

Keywords: Bladder cancer; Button electrode; En bloc.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / surgery*
  • Disease-Free Survival
  • Electrosurgery / adverse effects
  • Electrosurgery / instrumentation
  • Electrosurgery / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Operative Time
  • Tumor Burden
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery*
  • Urologic Surgical Procedures / adverse effects
  • Urologic Surgical Procedures / instrumentation
  • Urologic Surgical Procedures / methods*