Journal Article

In all fields anatomical dissection has improved results - en bloc resection of bladder tumors (ERBT) will make no exception

Herrmann, Thomas R. W., Guven, Selcuk

2025

Overview

While the study observed a higher rate of bladder perforations in the ERBT group, previous studies report conflicting outcomes (Table 2) [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15–16]. In Gallioli et al., perforation rates were 17% for cTURBT and 20% for ERBT, showing no significant difference in outcomes such as operative time or hospital stay [13]. A few studies presented mixed outcomes, highlighting the importance of achieving both safe resection and optimal pathological evaluation, particularly in maintaining accurate staging (Table 3). Summary of Randomized studies reporting bladder perforation outcomes in ERBT compared to cTURBT, highlighting inclusion criteria, outcomes, Perforation Rates, and EBRUC II Trial results for comparison Author (year) Inclusion criteria Energy source Patients, n Tumor size(cm), mean (SD) Number of lesions, mean (SD) Irrigation time (h), mean (SD) Bladder perforation, n (%) Muscle sampling Follow up (mo) Total ERBT/cTURBT ERBT cTURBT ERBT cTURBT ERBT cTURBT ERBT cTURBT ERBT cTURBT Liu (2013) [2] Primary NMIBC, not MIBC or CIS Thulium 120 64/56 1.3 (0.2) 1.3 (0.3) 2.8 (1.2) 2.7 (1.5) 8.2 (1.3) 14.5 (2.1) 0 5 (8.9) NA NA 36 Zhang (2015) [4] Primary NMIBC Thulium 292 149/143 NA NA Single: 52% Single: 55% 0 6 (4.2) NA NA 36 Huang (2016) [5] Primary NMIBC Holmium 140 70/70 1.6 (0.5) 1.5 (0.2) 2.4 (1.3) 2.5 (1.2) 14 (20) 6 (8.6) 0 5 (7.1) NA NA 24 Gakis (2020) [6] Primary or recurrent NMIBC, > 0.5 cm, ≤cT1, < 5 tumors HybridKnife 115 56/59 NA NA NA NA NA NA 1 (1.8) 1 (1.7) 41 (77.4) 36 (66.7) 12 Lu (2020) [7] Primary NMIBC Holmium 218 109/109 NA NA NA NA NA NA 0 8 (7.3) NA NA 24 Fan (2021) [8] Primary NMIBC, < 3 cm Green-light 233 116/117 1.5 (1.2–1.5) 1.5 (1–2) 1 (1–1.7) 1 (1–1) b NA NA 0 1 (0.9) 104 (89.7) 84 (71.8) 48 Razzaghi (2021) [9] Primary NMIBC Holmium 79 40/39 2 (1.1) 2.2 (0.8) Single: 63% Single: 59% NA NA 0 3 (7.7) NA NA 18 Mohamed Samy Shahin (2021) [10] Primary papillary NMIBC, single lesion, 1–3 cm Holmium 52 26/26 NA NA NA NA 7.6 (2.5) 1 (3.8) 1 (3.8) 3 (11.5) NA NA NA Tripathi (2021) [11] Primary or recurrent NMIBC, ≤ 3 lesions, and/or ≤ 3 cm Green light 83 40/43 1.7 (0.6) 1.7 (0.6) Single: 87.5% Single: 83.7% NA NA 0 0 22 (55) 24 (55.8) NA Badawy (2023) [12] Pr NMIBC < 4 cm, not the anterior wall or bladder dome tm Thulium 120 60/60 1.8 (0.5) 1.8 (0.6) Single: 96.7% Single: 91.7% NA NA 2 (3.3) 9 (15) 57 (95) 44 (73.3) 12 Gallioli (2022) [13] primary or recurrent tm, ≤ 3 cm, max 3 lesions, Monopolar Bipolar Thulium 248 140/108 NA NA NA NA 12 (12–24) 28 (20) 28 (20) 18 (17) 133 (95) 101 (94) 15 D’Andrea (2023) [14] Primary tm, stage, 1–3 cm, maximum of 3 tumors Monopolar Bipolar Laser 384 178/179 1.9 (1–2) 1.7 (1–2.5) NA NA NA NA 12 (5.6) 28 (12) 177 (81) 166 (71) 13 Wu (2023) [15] Primary or recurrent Tm, ≤ 4 lesions, and/or ≤ 2 cm Blue laser 174 85/89 1.4 (0.6) 1.3 (0.6) 1 (1–3) 1 (1–3) NA NA 0 1 (1.1) NA NA NA Yuen-Chun Teoh (2024) [16] Tm < 3 cm, not detected during intravesical BCG therapy Bipolar 276 143/133 1.5 (1–2) 2 (1–2) Single: 68% Single: 65% 26 (18) 18 (14) 0 0 112 (84) 119 (83) 12 Struck (2024) [1] Tumour size > 4.3 mm, no restrictions on number of tumours, tumour location, or tumour size Bipolar Monopolar Holmium 97 57/40 2.01 (1.13) 2.6(1.2) Single 72.7% Number 2.3 (0.7) Single 78% Number 2 (0) 21.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Bladder cancer / Correspondence / Lesions / Medicine / Medicine & Public Health / Nephrology / Oncology / Statistical power / Surgeons / Tumors / Urology