The clinical efficacy of transurethral plasma needle electrode en bloc resection of bladder cancer

Abstract

Objective To summarize the clinical experience and analyze the efficacy of transurethral plasma needle electrode en bloc resection for bladder cancer. Methods From February 2015 to August 2016, a total of 26 patients, including 21 males and 5 females, with bladder cancer received transurethral plasma needle electrode en bloc resection of bladder tumor. Their age ranged from 42 to 75 years, mean (56±13)years. The size of tumor ranged from 1 to 4 cm, mean (2.3±1.6)cm. The solitary tumor was found in 19 cases and multiple tumors were found in 7 cases, including 2 tumors in 5 cases, 3 tumors in 2 cases. In 6 cases, the tumor located in the lateral bladder wall. All the pre-operative biopsy showed the urethelial carcinoma in all cases, No bladder extravasion or upper urinary tumor was noticed in the CTU before surgery.By using the electrode needle tip inserted into the bladder mucosa, blunt release or cut the tumor bases until the deep muscularis or the serosal layer, complete removal of the tumor. The specimen was removed from the bladder and sent to the pathological examination.The operation time, the volume of blood loss during operation, surgical complications, pathological diagnosis and the wounds recovery were recorded and analyzed. Results All surgeries were undergone successfully. Totally 35 tumors were resected with diameter of 1.0-4.0 cm, mean (2.3±1.6)cm. The estimated blood loss was less than 10 ml. The operative duration ranged from 20 to 50 min, mean (30±16)min. The duration for removing the single tumor ranged from 5 to 25 min. No obturator nerve reflex were observed during surgery. No blood loss and complications occurred after operation. All patients received 30 mg pirarubicin bladder instillation chemotherapy immediately and no adverse reaction was noticed. Postoperative pathological stages of enrolled cases were distributed as 33 cases of T1G1 staging, 2 cases of T1G3 staging. No positive margin was observed. 3 months after operation, cystoscopy showed that the wound healed well. A total of 26 cases followed up for 3-10 months (mean 6.0±2.3 months). No one developed recurrence. Conclusions Transurethral plasma needle electrode en bloc resection of bladder tumor would reduce the incidence of complications and obturator nerve reflex. It can provide sufficient specimens for histological diagnosis. Key words: Bladder tumor; Transurethral resection of bladder tumor; Plasma needle electrode; The en bloc resection.