MP65-06 COLLINS LOOP EN BLOC RESECTION ( CLEBR) FOR ACCURATE STAGING OF PRIMARY NON MUSCLE INVASIVE BLADDER CANCER: EARLY EXPERIENCE

Abstract

You have accessJournal of UrologyBladder Cancer: Staging1 Apr 2014MP65-06 COLLINS LOOP EN BLOC RESECTION ( CLEBR) FOR ACCURATE STAGING OF PRIMARY NON MUSCLE INVASIVE BLADDER CANCER: EARLY EXPERIENCE Rodlolfo Hurle, Silvia Zandegiacomo De Zorzi, Luigi Castaldo, Luisa Pasini, Gianluigi Taverna, Paolo Puppo, Angelo Naselli, and Pierpaolo Graziotti Rodlolfo HurleRodlolfo Hurle More articles by this author , Silvia Zandegiacomo De ZorziSilvia Zandegiacomo De Zorzi More articles by this author , Luigi CastaldoLuigi Castaldo More articles by this author , Luisa PasiniLuisa Pasini More articles by this author , Gianluigi TavernaGianluigi Taverna More articles by this author , Paolo PuppoPaolo Puppo More articles by this author , Angelo NaselliAngelo Naselli More articles by this author , and Pierpaolo GraziottiPierpaolo Graziotti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1903AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A primary aim of transurethral resection of bladder tumors is to determine the depth of invasion or clinical stage. Transurethral resection is a stochastic procedure subject to variations in tumor type, surgical technique and pathological evaluation.One limiting factor is the surgical ‘incise and scatter’ technique that might contribute to tumour recurrence.We present initial results with using a Collins loop en bloc resection of bladder tumours for treatment and accurate staging of solitary transitional cell carcinoma of the bladder. METHODS April 2011-February 2013,67 patients(48 male – 19 female with non muscle-invasive bladder cancer (NMIBC) underwent transurethral en bloc resection using a Collins Loop. Tumor size ranged to 0.5- 45 mm and multifocality was present in 6% of cases. En bloc resection was applied on all of the tumours. On 59 of the 67 patients, a re-resection was performed after 6 weeks. The bladder wall is incised around the lesion using a Collins loop, starting from apparently ‘ normal ’ mucosa surrounding the base and then extending through the subepithelial connective tissue, muscularis mucosae and muscularis propria strata. The resected 1-piece specimen was grasped with a loop electrode and retrieved. After bladder tumor resection the resected base was observed carefully to assess perforation and bleeding. When the tumor size was greater than 3 cm, excision of the lesion could be easily achieved by mean of a resectoscope with a 5 mm working channel. After resection, the lesion is grasped with the forceps and retrieved with the resectoscope. All cases of high-risk NMIBC underwent second-look after 30-45 days. RESULTS Pathology reported urothelial carcinoma with low grade stage Ta, T1 high –grade and T2 high-grade respectively in 38 ( 56,7% ), 23 ( 34,3%), 6 ( 8,9%). All of the resected specimens provided detrusor muscle, no uncontrollable bleeding, perforation or other serious complications were observed. To date, with a mean follow up of 16.5 months, the recurrence rate in patients with NMIBC is 13.5% CONCLUSIONS CLebR has been proven safe and effective for both, treatment and pathological staging of NMIBC.The objective advantage of accurate pathological examination ( identification of microfocal invasion of lamina propria or of muscular wall, surgical margins assessment) is associated with a substantial safe technique. Long term data and larger dataset of cases are necessary to demonstrate an advantage in terms of recurrence or progression. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e693 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Rodlolfo Hurle More articles by this author Silvia Zandegiacomo De Zorzi More articles by this author Luigi Castaldo More articles by this author Luisa Pasini More articles by this author Gianluigi Taverna More articles by this author Paolo Puppo More articles by this author Angelo Naselli More articles by this author Pierpaolo Graziotti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...