In follow-up, all patients underwent standard re-resection at 4 weeks, followed by 1 year of BCG therapy (protocol uncertain). Routine guideline cystoscopy surveillance was used. Outcomes measured were: intraoperative complications, perioperative outcomes, and oncologic outcomes (identification of tumor on re-resection, recurrence rates).
* Rates compared but no statistical analysis completed
Intraoperative complications: Lower obturator reflex rates with BPV (8 vs. 31%) and lower bladder perforation with BPV (0.9 vs. 6.4%). No perioperative complications: There was less of a hemoglobin drop, shorter catheterization periods and shorter hospital stay (2.9 vs. 4.2 days) in patients undergoing BVP.
Oncologic Outcomes: The re-TUR rate of persistent malignancy and the rate of residual tumor at primary resection site were lower with BVP technique. The 1, 2 and 3-year recurrence rates were lower with BVP technique.
Ultimately, this entire paper was an anecdotal study – unfortunately, the statistical rigor is lacking. Additional, it is unclear what is being tested – NBI or bipolar energy. Two variables makes the results difficult to analyze, as it is unclear which variable is responsible for the outcomes.
Additionally, some of the outcomes are concerning. Hospital LOS 2-4 days for TURBT is too long already. 6% rate of gross perforation seems quite high. Overall, data is inconsistent.
No conclusions can be drawn from this study. More rigorous study design is required with better statistical analysis.
Presented by: Bogdan Geavlete
Affiliation: Saint John Clinical Emergency Hospital, Romania
Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, Twitter: @tchandra_uromd at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal