Comparison of transurethral bipolar plasma kinetic enucleation versus resection for the treatment of non-muscle-invasive bladder cancer: a case control study

Abstract

Objective To compare the effectiveness and safety of transurethral bipolar plasma kinetic enucleation with resection for the treatment of non-muscle-invasive bladder cancer(NMIBC). Methods The data of 160 patients diagnosed with suspected T1N0M0-NMIBC from August 2013 to August 2018 were analyzed retrospectively. Eighty patients were performed with transurethral bipolar plasma kinetic enucleation of bladder tumor(TUEBT) under the general anesthesia or combined spinal-epidural anesthesia with obturator nerve block. The others were performed with transurethral bipolar plasma kinetic resection of bladder tumor(TURBT). Results There were no statistical difference in preoperative clinical data between the two groups. The procedures were successfully performed in all patients with no patient requiring blood transfusion. No patient had bladder perforation and obturator nerve reflex during procedure. No statistical difference was found in operative time, rate of bladder perforation, postoperative pathological grading, postoperative pathological T staging, and follow-up time between the two groups. There were statistical difference in blood loss [(15±7) ml vs (6±2) ml,P<0.05], hospital stay [(5.8±2.3) d vs (3.6±1.4) d,P<0.05], the rate of secondary resection of bladder tumor (70.00% vs 36.25%,P<0.05), and tumor reccurence within 2 years (47.50% vs 31.25%,P<0.05) between the two groups. Conclusion TURBT and TUEBT are effective and safe procedures for managing NIMIBC. The operative specimens of TUEBT included bladder detrusor muscle in favor of judging the tumor stage. TUEBT of NIMIBC could reduce the rate of secondary resection of bladder tumor, shorten the hospital stay and decrease tumor recurrent rate compared with TURBT. Key words: Bladder tumor; Transurethral resection; Bipolar plasma kinetic; Enucleation