Early Complications of Endoscopic Treatment for Superficial Bladder Tumors

Collado, A.; Chéchile, G; Salvador, José; Vicente, J.

doi:10.1016/s0022-5347(05)67021-8

Cited by 156 publications

(68 citation statements)

References 5 publications

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“…Not only does it increase the risk of bleeding and injury of extravesical structures, but it also carries the potential risk for tumor seeding outside the bladder into the extra- or intraperitoneal cavities. The rates of adductor contractions during TURBTs have ranged from 1.7 to 11 % [12–14] but seem to be underreported in the literature if not accompanied by a serious complication. Nevertheless, because of its potential hazard in causing complications, measures should be taken to avoid the reflex to allow for complete and safe tumor resection.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

et al. 2014

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Objective To determine whether the Gyrus ACMI plasma kinetic bipolar device (Gyrus ACMI, Southborough, MA) improves pathologic specimen preservation and clinical outcomes compared to standard monopolar electrocautery. Patients and methods In our prospective study, 83 patients underwent monopolar or bipolar transurethral resection of bladder tumors between April 2006 and February 2007 at Memorial Sloan-Kettering Cancer Center. Dedicated genitourinary oncology pathologists blinded to resection type and assessed pathologic features including stage and grade, presence of muscularis propria, fragment size, presence and thickness of thermal artifacts within the specimen, layer of tissue most affected, severity of tissue distortion, and diagnostic impact of thermal artifacts. Clinical outcomes including, perforation, obturator reflex, need for muscle paralysis, a catheter, or admission, were recorded. Clinical and pathologic outcomes between resection modality were compared. Results There were no significant thermal artifacts in 9/38 (23.7 %) and 11/45 (24.4 %) monopolar and bipolar specimens, respectively. The layer of bladder tissue most affected by thermal artifacts was readable in 18/38 (47.4 %) monopolar and 27/45 (60.0 %) bipolar specimens. Tissue distortion from thermal artifacts led to areas within 11/38 (28.9 %) monopolar and 7/45 (15.6 %) bipolar specimens being unreadable. Ultimately, thermal artifacts caused moderate diagnostic difficulty in 2/38 (5.3 %) specimens of the monopolar group and severe diagnostic difficulty in 1/45 (2.2 %) bipolar specimens. Clinically, there was no major difference between resection methods. Conclusion Plasma kinetic bipolar equipment appears to cause less tissue distortion and has the potential to facilitate staging and grading of bladder tumors. No differences in clinical outcomes were appreciated between resection methods. If these results can be repeated in larger studies, the bipolar device represents a small advancement in transurethral resection.

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Section: Discussionmentioning

confidence: 99%

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

et al. 2014

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“…[18] have reported 13% incidence of hemorrhage while Collado et al . [1] have reported 3.4% incidence of blood transfusion. Lower preoperative hemoglobin levels may be responsible for more transfusions in our study.…”

Section: Discussionmentioning

confidence: 99%

“…The only shortcoming with subarachnoid block is sparing of the obturator nerve with a potential complication of bladder rupture or injury secondary to adductor muscle contraction from obturator nerve stimulation (obturator reflex) during transurethral resection of bladder tumor (TURBT). [1] The obturator nerve is derived from the 3 rd to 4 th lumbar nerves with a minor contribution from L2. The nerve descends on psoas muscle and lies deep in obturator canal (which is bordered by the obturator membrane, obturator muscles, and superior pubic ramus) from which it exists and divides into anterior and posterior branches.…”

Section: Introductionmentioning

confidence: 99%

Obturator nerve block in transurethral resection of bladder tumor: A comparative study by two techniques

Sharma

Agarwal

et al. 2017

Anesth Essays Res

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Context:Sparing of obturator nerve is a common problem encountered during transurethral resection of bladder tumor (TURBT) under spinal anesthesia.Aims:To evaluate and compare obturator nerve block (ONB) by two different techniques during TURBT.Settings and Design:This is prospective observational study.Subjects and Methods:Forty adult male patients from the American Society of Anesthesiologists Class I–IV planned to undergo TURBT under spinal anesthesia were divided into two groups of twenty each. In one group, ONB was performed with nerve locator. In other group, transvesical nerve block was performed with a cystoscope. The primary endpoints of this study were the occurrence of adductor reflex, ability to resect the tumor, and number of surgical interruptions. A number of transfusions required and bladder perforation were the secondary endpoints.Results:There was statistically significant difference between the groups for resection without adductor jerk, resection with a minimal jerk, and unresectable with high-intensity adductor jerk. Bleeding was observed in both groups and one bladder perforation was encountered.Conclusions:We conclude that ONB, when administered along with spinal anesthesia for TURBT, is extremely safe and effective method of anesthesia to overcome adductor contraction. ONB with nerve locator appears to be more effective method compared to the transvesical nerve block.

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“…Primary perforations are full-thickness lesions of the bladder wall due to the TUR. Literature suggests that the incidence of clinically symptomatic perforations during TUR is low [18,23]. However, small asymptomatic perforations of the bladder are probably not rare at all.…”

Section: Discussionmentioning

confidence: 99%

Extravasation of Intravesical Chemotherapy for Non-Muscle-Invasive Bladder Cancer

Mertens¹,

Meinhardt²,

Rier³

et al. 2012

Urol Int

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Purpose: To report our experience with symptomatic extravasation of intravesical chemotherapy administered within 24 h after transurethral resection (TUR) over the past 10 years. Methods: We identified all consecutive patients who presented with symptomatic extravasation of intravesical chemotherapy following TUR between 2001 and 2011. We assessed the severity of the postoperative complications using the modified Clavien system. Results: We identified 9 patients (mean age 59, range 40–76 years) with symptomatic extravasation. One patient had grade II, 2 had grade IIIa, and 5 patients had grade IIIb complications according to the Clavien system. Surgery was needed in 6 of 9 patients. One required ICU management (Clavien IV). No patients died in the postoperative course. Conclusion: Extravasation can cause severe complications and diagnosis is often protracted. Considering the growing practice of immediate intravesical instillations, the number of patients with symptomatic extravasation is expected to rise. An increased awareness of this possible complication is warranted.

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Early Complications of Endoscopic Treatment for Superficial Bladder Tumors

Cited by 156 publications

References 5 publications

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

Obturator nerve block in transurethral resection of bladder tumor: A comparative study by two techniques

Extravasation of Intravesical Chemotherapy for Non-Muscle-Invasive Bladder Cancer

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