1651 BIPOLAR PLASMA VAPORIZATION AND NBI FOR LARGE NON-MUSCLE INVASIVE BLADDER TUMORS – RESULTS OF A PROSPECTIVE, RANDOMIZED, LONG-TERM COMPARISON TO THE STANDARD APPROACH

Abstract

You have accessJournal of UrologyBladder Cancer: Superficial1 Apr 20111651 BIPOLAR PLASMA VAPORIZATION AND NBI FOR LARGE NON-MUSCLE INVASIVE BLADDER TUMORS – RESULTS OF A PROSPECTIVE, RANDOMIZED, LONG-TERM COMPARISON TO THE STANDARD APPROACH Bogdan Geavlete, Razvan Multescu, Florin Stanescu, Dragos Georgescu, Marian Jecu, and Petrisor Geavlete Bogdan GeavleteBogdan Geavlete Bucharest, Romania More articles by this author , Razvan MultescuRazvan Multescu Bucharest, Romania More articles by this author , Florin StanescuFlorin Stanescu Bucharest, Romania More articles by this author , Dragos GeorgescuDragos Georgescu Bucharest, Romania More articles by this author , Marian JecuMarian Jecu Bucharest, Romania More articles by this author , and Petrisor GeavletePetrisor Geavlete Bucharest, Romania More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1761AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This study aimed to evaluate the diagnostic accuracy and surgical efficacy of a new diagnostic and treatment approach consisting of narrow band imaging cystoscopy (NBIC) associated with bipolar plasma vaporization (BPV) by comparison to standard white light cystoscopy (WLC) and monopolar transurethral resection (TURBT) in cases of large bladder tumors. Re-TUR and long-term recurrence rates were also assessed. METHODS A total of 210 patients with bladder tumors over 3 cm were included in the trial based on abdominal ultrasonography, computer tomography and flexible WLC. In one arm, 105 patients underwent WLC and NBIC, followed by BPV, while in the other 105 cases, only WLC and TURBT were performed. All NMIBC patients underwent standard Re-TUR 4 weeks after the initial procedure and follow-up urinary cytology and WLC at 3, 6, 9 and 12 months. RESULTS The preoperative parameters were similar in the two study groups. The CIS, pTa, pT1 and overall tumors' detection rates in the NBIC-BPV arm were significantly improved for NBIC by comparison to WLC (95% versus 62.5%, 91% versus 78.1%, 95.7% versus 89.2% and 93.4% versus 80.6%). The rate of false positive results was 15.5% for NBIC versus 12.2% for WLC. The operation time, catheterization period and hospital stay were significantly shorter in the BPV arm. The obturator nerve stimulation, bladder wall perforation, mean hemoglobin drop, postoperative bleeding and blood transfusion rate were significantly reduced for BPV by comparison to monopolar TURBT. The residual tumors' rates at Re-TUR for overall, primary site and initial multiple tumors' were significantly lower in the NBIC-BPV arm (8.4% versus 20.6%, 7.4% versus 18.5% and 8.5% versus 21.2%). The one year recurrence rate was significantly reduced in the NBIC-BPV group (18.9% versus 35.1%). CONCLUSIONS NBIC significantly improved the diagnostic accuracy in NMIBC. BPV emphasized superior efficacy and reduced complication rate by comparison to TURBT. This combined new diagnostic and treatment approach provided a lower residual tumors' rate at Re-TUR and a reduced recurrence rate during the one year follow-up. Perioperative parameters BPV TURBT Operation time 19.1min 31.3min Catheterization period 2.5days 3.5days Hospital stay 3.5days 4.5days Obturator nerve stimulation 3.6% 19.1% Bladder wall perforation 0.9% 6.4% Mean hemoglobin drop 0.2g/dl 0.9g/dl Postoperative bleeding 0.9% 5.5% Blood transfusion 0.9% 4.5% © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e663 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bogdan Geavlete Bucharest, Romania More articles by this author Razvan Multescu Bucharest, Romania More articles by this author Florin Stanescu Bucharest, Romania More articles by this author Dragos Georgescu Bucharest, Romania More articles by this author Marian Jecu Bucharest, Romania More articles by this author Petrisor Geavlete Bucharest, Romania More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...