Conventional transurethral resection (TURBT) with tumor fragmentation is the primary step in the surgical treatment of nonmuscle invasive bladder cancer. Recently, new surgical techniques and training modalities have emerged with the aim to overcome short-comings of TURBT and improve oncologic outcomes. In this review, we provide a comprehensive update of recent techniques/techniques that aim to improve upon conventional TURBT and beyond.
A systemic approach during conventional TURBT that features the use of a surgical checklist has been shown to improve recurrence-free survival. Several simulators have been developed and validated to provide additional training opportunities. However, transfer of improved simulator performance into real world surgery still requires validation. While there is no convincing data that demonstrate superior outcomes with bipolar TURBT, en-bloc resection already promises to offer lower rates of complications as well as potentially lower recurrence probabilities in select patients.
TURBT remains the quintessential procedure for the diagnosis and treatment of bladder cancer. Urologists need to be aware of the importance and challenges of this procedure. Aside of embracing new resection techniques and a conceptual-systematic approach, training opportunities should be expanded upon to improve patient outcomes.
Current opinion in urology. 2021 May 10 [Epub ahead of print]
Victor M Schuettfort, Benjamin Pradere, Eva Compérat, Mohammad Abufaraj, Shahrokh F Shariat
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia Department of Urology, Weill Cornell Medical College, New York, New York Department of Urology, University of Texas Southwestern, Dallas, Texas, USA Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria European Association of Urology Research Foundation, Arnhem, The Netherlands.