A Prospective Trial of Flexible Cystodiathermy for Recurrent Transitional Cell Carcinoma of the Bladder

Wedderburn, Andrew; Ratan, P.; Birch, Brian

doi:10.1016/s0022-5347(01)61778-6

Cited by 43 publications

(13 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of cystodiathermy delivered under local anaesthetic to reduce the risks associated with general anaesthetic in this patient population has been previously explored and is widely used, particularly in North America. Recent studies suggest its use is limited by tolerability as 12% of patients find the procedure painful .…”

Section: Introductionmentioning

confidence: 99%

Outpatient laser ablation of non‐muscle‐invasive bladder cancer: is it safe, tolerable and cost‐effective?

et al. 2013

View full text Add to dashboard Cite

Objectives• To evaluate the safety, tolerability and effectiveness of outpatient (office-based) laser ablation (OLA), with local anaesthetic, for non-muscle-invasive bladder cancer (NMIBC) in an elderly population with and without photodynamic diagnosis (PDD).• To compare the cost-effectiveness of OLA of NMIBC with that of inpatient cystodiathermy (IC). Patients and Methods• We conducted a prospective cohort study of patients with NMIBC treated with OLA by one consultant surgeon between March 2008 and July 2011 • A subgroup of patients had PDD before undergoing OLA.• Safety and effectiveness were determined by complications (In the immediate post operative period, at three days and at three months), patient tolerability (visual analogue score) and recurrence rates.• The long-term costs and cost-effectiveness of OLA and IC of NMIBC were evaluated using Markov modeling. Results• A total of 74 OLA procedures (44 white-light, 30 PDD) were carried out in 54 patients. The mean (range) patient age was 77 (52-95) years. More than half of the patients had more than three comorbidities. Previous tumour histology ranged from G1pTa to T3. • One patient had haematuria for 1 week which settled spontaneously and did not require hospital admission. There were no other complications.• The procedure was well tolerated with pain scores of 0-2/10. • Additional lesions were found in 21% of patients using PDD that were not found using white light.• At 3 months, the percentage of patients who had recurrence after OLA with white light and OLA with PDD were 10.6 and 4.3%, respectively. At 1 year, 65.1% and 46.9% of patients had recurrence.• The cost of OLA was found to be much lower than that of IC (£538 vs £1474), even with the addition of PDD (£912 vs £1844).• Over the course of a patient's lifetime, OLA was more clinically effective, measured in quality-adjusted life-years (QALY), than IC (0.147 [SD 0.059]) and less costly (£2576.42 [SD £7293.07]).• At a cost-effectiveness threshold of £30 000/QALY, as set by the National Institute for Health and Care Excellence, there was an 82% probability that OLA was cost-effective. Conclusions• This is the first study to demonstrate the long-term cost-effectiveness of OLA of NMIBC.• The results support the use of OLA for the treatment of NMIBC, especially in the elderly.

show abstract

Section: Introductionmentioning

confidence: 99%

Outpatient laser ablation of non‐muscle‐invasive bladder cancer: is it safe, tolerable and cost‐effective?

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Alternatively, flexible cystoscopy treatment under local anesthesia (LA) with diathermy is widely used in clinical practice. 3,4 A limitation of this technique is pain perception, resulting in reduced patient tolerance of the procedure. 4 Complication rates for standard transurethral resection of bladder tumors (TURBT) are not insignificant, including urinary tract infections (UTI's) (up to 24%), bleeding (2.8%-8%), hemorrhage requiring transfusion (0.9%-13%), and bladder perforation (1.3%-5%).…”

Section: Introductionmentioning

confidence: 99%

Flexible Cystoscopy and Holmium:Yttrium Aluminum Garnet Laser Ablation for Recurrent Nonmuscle Invasive Bladder Carcinoma Under Local Anesthesia

Syed

Talbot

Abbas

et al. 2013

Journal of Endourology

View full text Add to dashboard Cite

Flexible cystoscopy and Ho:YAG laser therapy should be considered as a first line treatment option for the management of recurrence in low-grade NMIBC (G1/2, Ta/1) throughout the bladder, except around the ureteric orifices. For those with high-grade disease (G3), the recurrences rates are increased, but the procedure still offers an acceptable recurrence rate. It provides good local disease control, low complications, patient acceptability and tolerance.

show abstract

“…In addition, the new flexible video cystoscope provides us with a clear view of the resectoscope even for tumors at the 12 o’clock position or behind the adenoma. The main difference between the cystoscope we used and previous models is that high‐frequency cauterization can be performed at the same time that a digital signal picture is obtained 2,3 Hot biopsy, regular cauterization and hot snaring can also be used simultaneously with digital imaging. However, we recommend using a regular resectoscope if the tumor is flat and not pedunculated, and when a cold biopsy cup is used, it is advisable that each bleeding point is coagulated to maintain a good view.…”

Section: Discussionmentioning

confidence: 99%

Experience with flexible video cystoscope equipped with built‐in high‐frequency cauterizing element for transurethral resection of the bladder

et al. 2003

View full text Add to dashboard Cite

We successfully treated three patients using the flexible video cystoscope (CYF-240A, Olympus, Japan) for superficial bladder cancer under local anesthesia and/or spinal anesthesia. The major advantage of this new technique is that surgeons can use digital pictures and high frequency cauterization. This new system provides good quality of life for bladder cancer patients experiencing frequent recurrences.

show abstract

A Prospective Trial of Flexible Cystodiathermy for Recurrent Transitional Cell Carcinoma of the Bladder

Cited by 43 publications

References 16 publications

Outpatient laser ablation of non‐muscle‐invasive bladder cancer: is it safe, tolerable and cost‐effective?

Outpatient laser ablation of non‐muscle‐invasive bladder cancer: is it safe, tolerable and cost‐effective?

Flexible Cystoscopy and Holmium:Yttrium Aluminum Garnet Laser Ablation for Recurrent Nonmuscle Invasive Bladder Carcinoma Under Local Anesthesia

Experience with flexible video cystoscope equipped with built‐in high‐frequency cauterizing element for transurethral resection of the bladder

Contact Info

Product

Resources

About