Objective： To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor （TURBT）. Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spin...Objective： To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor （TURBT）. Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0. 75% pure bupivacaine （8-12 rag） was applied to patients in Group Ⅰ （n= 30）. Patients in Group Ⅱ （n=30） received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil ; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results ： The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ . Obturator nerve reflex was observed in 15 （50. 0%） patients in Group Ⅰ , but none （0%） in Group Ⅱ （P〈0. 01）. Conclusion.. Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.展开更多
BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a ...BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a potential threat to the patient’s life.CASE SUMMARY This paper reports a case of intravesical explosion during TUR-BT.Combined with the literature review,the risk factors are analyzed and measures of prevention and treatment are discussed.CONCLUSION Although rare,intravesical explosions can cause serious consequences,and the loud explosion can also lead to a profound psychological shadow on the patient.Urologists must be aware of this potential complication.Careful operative techniques and special precautions can reduce the risk of this complication.展开更多
Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at...Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at a urology center in Douala, Cameroon. Patients and Methods: This was a retrospective study carried out from 2015 to 2019 on 32 patients with bladder tumors that were managed at the Centre medico-chirugical d’urologie in Douala, Cameroon. The relevant data were obtained from patients’ clinical records. Results: A total of 32 patients (25 men and 7 women) aged 29 - 75 years were included in this study. The mean age of the study participants was 58.63 ± 11.00 years. Among our study participants, there were 10 smokers (31.25%). Eight (25%) of them had occupational exposure while 2 (6.25%) had residential exposure to bladder cancer. Thirty (93.75%) presented with hematuria, 2 (6.25%) presented with recurrent urinary tract infections, and 1 (3.13%) presented with acute urinary colic. Nineteen (59.38%) of them were anemic, with 4 (12.5%) requiring blood transfusions. Twenty-seven (84.38%) of them had pedunculated tumors while 5 (15.62%) had sessile tumors. The tumor diameters ranged from 1 cm to 5 cm, with a mean diameter of 2.75 ± 1.22 cm. Complete resection was performed in 27 (84.38%) participants while partial resection was performed in 5 (15.62%) patients. The early single instillation of intravesical chemotherapy with mitomycin was performed in 8 (25%) patients. Only one (3.13%) patient had a postoperative complication, and seven (21.88%) patients experienced tumor recurrence and underwent a second TURBT. Two (6.25%) of the 32 patients died and 30 (93.75%) survived. Conclusion: TURBT is the gold standard method of managing bladder tumors. This procedure is at the same time diagnostic and therapeutic for tumors that do not invade the walls of the urinary bladder.展开更多
Bladder cancer(BC)ranks as the tenth most common cancer globally.Histopathologically,BC is broadly categorized into urothelial and non-urothelial BC.Urothelial carcinoma represents over 90%of BC in most regions worldw...Bladder cancer(BC)ranks as the tenth most common cancer globally.Histopathologically,BC is broadly categorized into urothelial and non-urothelial BC.Urothelial carcinoma represents over 90%of BC in most regions worldwide.The standard treatment procedure for diagnosing and treating non-muscle-invasive bladder cancer(NMIBC)is transurethral resection of bladder tumors(TURBT).Currently,the standard of care for muscle-invasive bladder cancer(MIBC)is neoadjuvant chemotherapy followed by radical cystectomy.Cryoablation therapy is a medical technique that uses extremely low temperatures to destroy diseased tissue.This treatment serves as a therapeutic tool for both benign and malignant diseases in organs such as the kidney,prostate gland,lung,liver,and breast,and is particularly effective for unresectable tumors,offering less trauma,quick recovery,good tolerability,and symptom control.However,cryoablation has its limitations.Over the past few years,cryoablation therapy has emerged as a new method for treating early BC.This treatment is minimally invasive,precise,and offers quick recovery,providing patients with a new treatment option.Although randomized studies are still limited,increasing evidence suggests its potential application in bladder cancer combined with transurethral resection(TURBT)or medication.Cryoablation is not standard therapy for bladder cancer.Treatment decisions should be discussed by a multidisciplinary team of urologists,oncologists,and interventional physicians and require more randomized controlled trials to define patient selection criteria and treatment approaches.展开更多
Bladder tumor is characterized by recurrent recurrence and distant metastasis,which determines the difficulty of completely curing bladder tumor.In recent years,the number of patients with bladder cancer is increasing...Bladder tumor is characterized by recurrent recurrence and distant metastasis,which determines the difficulty of completely curing bladder tumor.In recent years,the number of patients with bladder cancer is increasing,and the treatment of bladder cancer has become an important direction of clinical research.It is difficult to control bladder tumor by traditional therapy.Photodynamic therapy(PDT),as a new optical therapy,has gradually become the main method in clinical treatment of bladder tumor combined with transurethral resection of bladder tumor.In this paper,a patient with superficial recurrent bladder tumor was treated by photodynamic therapy combined with transurethral resection of bladder tumor.The advantages of photodynamic therapy in the treatment of bladder tumor and the selection of photosensitizer in the process of photodynamic therapy were discussed.After two recurrences,the patients chose photodynamic therapy.The tumors were resected one by one,and the wound was coagulated by roller electrode.After the drug was retained for 20 minutes,the bladder was empty.The spherical optical fiber was implanted into the bladder.The photodynamic energy was adjusted(light power 1.8 W,light time 1302 s).There was no recurrence after operation.Most bladder tumors are superficial tumors,and bladder is a cavity organ,which determines that bladder is an ideal organ for photodynamic therapy.As a targeted drug,photosensitizer is only absorbed by bladder tumor after being perfused into bladder.The photosensitizer forms reactive oxygen species through oxygen and kills tumor cells.Clinical practice has proved that PDT has its unique advantages for superficial and recurrent bladder tumors.As the first generation photosensitizer,xipofen also has selectivity in the treatment of bladder cancer.展开更多
Background Transurethral resection of the bladder tumor （TURBT） remains the gold standard for non-muscle-invasive bladder cancer （NMIBC）. Laser techniques have been widely used in urology. This analysis aimed to a...Background Transurethral resection of the bladder tumor （TURBT） remains the gold standard for non-muscle-invasive bladder cancer （NMIBC）. Laser techniques have been widely used in urology. This analysis aimed to assess the safety and efficacy of holmium resection of the bladder tumor （HoLRBT）vs. TURBT. Methods A systemic search of MEDLINE, Embase, Web of Science, and The Cochrane Library as well as manual bibliography searches were performed to identify the relevant studies. The pooled estimates of operation time, obturator nerve reflex rate, bladder perforation rate, bladder irrigation rate, catheterization time, hospital stay, and one- and two-year recurrence free survivals were calculated. Results Five studies were enrolled into our meta-analysis. No significant difference was observed in the operation time between groups （weighted mean difference （WMD） 1.01, 95% confidential interval （95% CI） -3.52-5.54, P=0.66）. The significant difference in the obturator nerve reflex （OR 0.05, 95% CI 0.01-0.04, P=0.004）, bladder perforation （OR 0.14, 95% CI 0.03-0.61, P=-0.009）, bladder irrigation （OR 0.13, 95% CI 0.04-0.45, P=0.001）, catheterization time （WMD -0.96, 95% C1-1.11 to-0.82, P 〈0.00001）, and hospital stay （WMD-1.46, 95% C1-1.65 to-1.27, P 〈0.00001）showed advantages of HoLRBT over TURBT. The 2-year recurrence free survival rate favors the HoLRBT group （OR 1.46, 95% CI 1.02-2.11, P=-0.04）. Conclusions As a promising technique, HoLRBT is safe and efficient, and showed several advantages over TURBT. HoLRBT can be used as an alternative procedure for TURBT in terms of low-grade papillary urothelial carcinoma or low-grade early TNM-stage urothelial carcinoma.展开更多
Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management...Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management.In 2018,we issued“Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidencebased clinical practice guideline”.Since then,various studies on the treatment and surveillance of NMIBC have been published.There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China.Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated.We formed a working group of clinical experts and methodologists.Through questionnaire investigation of clinicians including primary medical institutions,24 clinically concerned issues,involving transurethral resection of bladder tumor(TURBT),intravesical chemotherapy and intravesical immunotherapy of NMIBC,and follow-up and surveillance of the NMIBC patients,were determined for this guideline.Researches and recommendations on the management of NMIBC in databases,guideline development professional societies and monographs were referred to,and the European Association of Urology was used to assess the certainty of generated recommendations.Finally,we issued 29 statements,among which 22 were strong recommendations,and 7 were weak recommendations.These recommendations cover the topics of TURBT,postoperative chemotherapy after TURBT,Bacillus Calmette–Guérin(BCG)immunotherapy after TURBT,combination treatment of BCG and chemotherapy after TURBT,treatment of carcinoma in situ,radical cystectomy,treatment of NMIBC recurrence,and follow-up and surveillance.We hope these recommendations can help promote the treatment and surveillance of NMIBC in China,especially for the primary medical institutions.展开更多
Objectives:To investigate the role of complete transurethral resection of bladder tumor(TURBT)before radical cystectomy(RC)for organ-confined bladder cancer.Materials and methods:Data of patients who underwent RC in o...Objectives:To investigate the role of complete transurethral resection of bladder tumor(TURBT)before radical cystectomy(RC)for organ-confined bladder cancer.Materials and methods:Data of patients who underwent RC in our center from January 2008 to December 2018 were retrospectively reviewed.Patients with>T2N0M0 disease and positive surgical margins and those who received neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded.Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT or in the bladder specimen after RC.Kaplan-Meier curves and log-rank tests assessed disease-free survival(DFS).Logistic and Cox regression analyses were performed to identify potential predictors.Results:A total of 236 patients were included in this review,including 207 males,with a median age of 61 years.The median tumor size was 3 cm,and a total of 94 patients had identified pathological T2 stage disease.Complete TURBT was correlated with tumor size(p=0.041),histological variants(p=0.026),and down-staging(p<0.001).Tumor size,grade,and histological variants were independent predictors of complete TURBT.During a median follow-up of 42.7 months,30 patients developed disease recurrence.Age and histological variants were independent predictors of DFS(p=0.022 and 0.032,respectively),whereas complete TURBT was not an independent predictor of DFS(p=0.156).Down-staging was not associated with survival outcome.Conclusions:Complete TURBT was correlated with an increased rate of down-staging before RC.It was not associated with better oncologic outcomes for patients with organ-confined bladder cancer.展开更多
文摘Objective： To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor （TURBT）. Methods.. Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0. 75% pure bupivacaine （8-12 rag） was applied to patients in Group Ⅰ （n= 30）. Patients in Group Ⅱ （n=30） received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil ; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results ： The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ . Obturator nerve reflex was observed in 15 （50. 0%） patients in Group Ⅰ , but none （0%） in Group Ⅱ （P〈0. 01）. Conclusion.. Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.
文摘BACKGROUND Intravesical explosion during transurethral resection of bladder tumor(TUR-BT)is a very rare complication,and it may result in rupture of the bladder,which usually requires surgical correction and causes a potential threat to the patient’s life.CASE SUMMARY This paper reports a case of intravesical explosion during TUR-BT.Combined with the literature review,the risk factors are analyzed and measures of prevention and treatment are discussed.CONCLUSION Although rare,intravesical explosions can cause serious consequences,and the loud explosion can also lead to a profound psychological shadow on the patient.Urologists must be aware of this potential complication.Careful operative techniques and special precautions can reduce the risk of this complication.
文摘Aim: This study aimed to determine the demographic, clinical, paraclinical, therapeutic, and evolutive characteristics of patients with bladder tumors who underwent transurethral resection of bladder tumors (TURBT) at a urology center in Douala, Cameroon. Patients and Methods: This was a retrospective study carried out from 2015 to 2019 on 32 patients with bladder tumors that were managed at the Centre medico-chirugical d’urologie in Douala, Cameroon. The relevant data were obtained from patients’ clinical records. Results: A total of 32 patients (25 men and 7 women) aged 29 - 75 years were included in this study. The mean age of the study participants was 58.63 ± 11.00 years. Among our study participants, there were 10 smokers (31.25%). Eight (25%) of them had occupational exposure while 2 (6.25%) had residential exposure to bladder cancer. Thirty (93.75%) presented with hematuria, 2 (6.25%) presented with recurrent urinary tract infections, and 1 (3.13%) presented with acute urinary colic. Nineteen (59.38%) of them were anemic, with 4 (12.5%) requiring blood transfusions. Twenty-seven (84.38%) of them had pedunculated tumors while 5 (15.62%) had sessile tumors. The tumor diameters ranged from 1 cm to 5 cm, with a mean diameter of 2.75 ± 1.22 cm. Complete resection was performed in 27 (84.38%) participants while partial resection was performed in 5 (15.62%) patients. The early single instillation of intravesical chemotherapy with mitomycin was performed in 8 (25%) patients. Only one (3.13%) patient had a postoperative complication, and seven (21.88%) patients experienced tumor recurrence and underwent a second TURBT. Two (6.25%) of the 32 patients died and 30 (93.75%) survived. Conclusion: TURBT is the gold standard method of managing bladder tumors. This procedure is at the same time diagnostic and therapeutic for tumors that do not invade the walls of the urinary bladder.
基金This work was supported by the 2023 Guangzhou Basic and Applied Basic Research Project(2023A04J2132).
文摘Bladder cancer(BC)ranks as the tenth most common cancer globally.Histopathologically,BC is broadly categorized into urothelial and non-urothelial BC.Urothelial carcinoma represents over 90%of BC in most regions worldwide.The standard treatment procedure for diagnosing and treating non-muscle-invasive bladder cancer(NMIBC)is transurethral resection of bladder tumors(TURBT).Currently,the standard of care for muscle-invasive bladder cancer(MIBC)is neoadjuvant chemotherapy followed by radical cystectomy.Cryoablation therapy is a medical technique that uses extremely low temperatures to destroy diseased tissue.This treatment serves as a therapeutic tool for both benign and malignant diseases in organs such as the kidney,prostate gland,lung,liver,and breast,and is particularly effective for unresectable tumors,offering less trauma,quick recovery,good tolerability,and symptom control.However,cryoablation has its limitations.Over the past few years,cryoablation therapy has emerged as a new method for treating early BC.This treatment is minimally invasive,precise,and offers quick recovery,providing patients with a new treatment option.Although randomized studies are still limited,increasing evidence suggests its potential application in bladder cancer combined with transurethral resection(TURBT)or medication.Cryoablation is not standard therapy for bladder cancer.Treatment decisions should be discussed by a multidisciplinary team of urologists,oncologists,and interventional physicians and require more randomized controlled trials to define patient selection criteria and treatment approaches.
文摘Bladder tumor is characterized by recurrent recurrence and distant metastasis,which determines the difficulty of completely curing bladder tumor.In recent years,the number of patients with bladder cancer is increasing,and the treatment of bladder cancer has become an important direction of clinical research.It is difficult to control bladder tumor by traditional therapy.Photodynamic therapy(PDT),as a new optical therapy,has gradually become the main method in clinical treatment of bladder tumor combined with transurethral resection of bladder tumor.In this paper,a patient with superficial recurrent bladder tumor was treated by photodynamic therapy combined with transurethral resection of bladder tumor.The advantages of photodynamic therapy in the treatment of bladder tumor and the selection of photosensitizer in the process of photodynamic therapy were discussed.After two recurrences,the patients chose photodynamic therapy.The tumors were resected one by one,and the wound was coagulated by roller electrode.After the drug was retained for 20 minutes,the bladder was empty.The spherical optical fiber was implanted into the bladder.The photodynamic energy was adjusted(light power 1.8 W,light time 1302 s).There was no recurrence after operation.Most bladder tumors are superficial tumors,and bladder is a cavity organ,which determines that bladder is an ideal organ for photodynamic therapy.As a targeted drug,photosensitizer is only absorbed by bladder tumor after being perfused into bladder.The photosensitizer forms reactive oxygen species through oxygen and kills tumor cells.Clinical practice has proved that PDT has its unique advantages for superficial and recurrent bladder tumors.As the first generation photosensitizer,xipofen also has selectivity in the treatment of bladder cancer.
文摘Background Transurethral resection of the bladder tumor （TURBT） remains the gold standard for non-muscle-invasive bladder cancer （NMIBC）. Laser techniques have been widely used in urology. This analysis aimed to assess the safety and efficacy of holmium resection of the bladder tumor （HoLRBT）vs. TURBT. Methods A systemic search of MEDLINE, Embase, Web of Science, and The Cochrane Library as well as manual bibliography searches were performed to identify the relevant studies. The pooled estimates of operation time, obturator nerve reflex rate, bladder perforation rate, bladder irrigation rate, catheterization time, hospital stay, and one- and two-year recurrence free survivals were calculated. Results Five studies were enrolled into our meta-analysis. No significant difference was observed in the operation time between groups （weighted mean difference （WMD） 1.01, 95% confidential interval （95% CI） -3.52-5.54, P=0.66）. The significant difference in the obturator nerve reflex （OR 0.05, 95% CI 0.01-0.04, P=0.004）, bladder perforation （OR 0.14, 95% CI 0.03-0.61, P=-0.009）, bladder irrigation （OR 0.13, 95% CI 0.04-0.45, P=0.001）, catheterization time （WMD -0.96, 95% C1-1.11 to-0.82, P 〈0.00001）, and hospital stay （WMD-1.46, 95% C1-1.65 to-1.27, P 〈0.00001）showed advantages of HoLRBT over TURBT. The 2-year recurrence free survival rate favors the HoLRBT group （OR 1.46, 95% CI 1.02-2.11, P=-0.04）. Conclusions As a promising technique, HoLRBT is safe and efficient, and showed several advantages over TURBT. HoLRBT can be used as an alternative procedure for TURBT in terms of low-grade papillary urothelial carcinoma or low-grade early TNM-stage urothelial carcinoma.
基金suppor ted by the National Key Research and Development Plan of China(Technology helps Economy 2020,2016YFC0106300)the National Natural Science Foundation of China(82174230)the Major Program Fund of Technical Innovation Project of Department of Science and Technology of Hubei Province(2016ACAl52)。
文摘Non-muscle invasive bladder cancer(NMIBC)is a major type of bladder cancer with a high incidence worldwide,resulting in a great disease burden.Treatment and surveillance are the most important part of NIMBC management.In 2018,we issued“Treatment and surveillance for non-muscle-invasive bladder cancer in China:an evidencebased clinical practice guideline”.Since then,various studies on the treatment and surveillance of NMIBC have been published.There is a need to incorporate these materials and also to take into account the relatively limited medical resources in primary medical institutions in China.Developing a version of guideline which takes these two issues into account to promote the management of NMIBC is therefore indicated.We formed a working group of clinical experts and methodologists.Through questionnaire investigation of clinicians including primary medical institutions,24 clinically concerned issues,involving transurethral resection of bladder tumor(TURBT),intravesical chemotherapy and intravesical immunotherapy of NMIBC,and follow-up and surveillance of the NMIBC patients,were determined for this guideline.Researches and recommendations on the management of NMIBC in databases,guideline development professional societies and monographs were referred to,and the European Association of Urology was used to assess the certainty of generated recommendations.Finally,we issued 29 statements,among which 22 were strong recommendations,and 7 were weak recommendations.These recommendations cover the topics of TURBT,postoperative chemotherapy after TURBT,Bacillus Calmette–Guérin(BCG)immunotherapy after TURBT,combination treatment of BCG and chemotherapy after TURBT,treatment of carcinoma in situ,radical cystectomy,treatment of NMIBC recurrence,and follow-up and surveillance.We hope these recommendations can help promote the treatment and surveillance of NMIBC in China,especially for the primary medical institutions.
基金supported by the Fundamental Research Fund for Central Universities(grant 20ykpy179)Medical Science Fund of Guangdong Province(A2020139).
文摘Objectives:To investigate the role of complete transurethral resection of bladder tumor(TURBT)before radical cystectomy(RC)for organ-confined bladder cancer.Materials and methods:Data of patients who underwent RC in our center from January 2008 to December 2018 were retrospectively reviewed.Patients with>T2N0M0 disease and positive surgical margins and those who received neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded.Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT or in the bladder specimen after RC.Kaplan-Meier curves and log-rank tests assessed disease-free survival(DFS).Logistic and Cox regression analyses were performed to identify potential predictors.Results:A total of 236 patients were included in this review,including 207 males,with a median age of 61 years.The median tumor size was 3 cm,and a total of 94 patients had identified pathological T2 stage disease.Complete TURBT was correlated with tumor size(p=0.041),histological variants(p=0.026),and down-staging(p<0.001).Tumor size,grade,and histological variants were independent predictors of complete TURBT.During a median follow-up of 42.7 months,30 patients developed disease recurrence.Age and histological variants were independent predictors of DFS(p=0.022 and 0.032,respectively),whereas complete TURBT was not an independent predictor of DFS(p=0.156).Down-staging was not associated with survival outcome.Conclusions:Complete TURBT was correlated with an increased rate of down-staging before RC.It was not associated with better oncologic outcomes for patients with organ-confined bladder cancer.
