Transurethral Resection of Non-muscle-invasive Bladder Cancer
Transurethral Resection of Non-muscle-invasive Bladder Cancer
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DOI：
10.1016/j.eursup.2009.06.003
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发表时间：
2009-09-01
影响因子：
--
通讯作者：
Babjuk, Marko
中科院分区：
文献类型：
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作者：
Babjuk, Marko
经尿道膀胱切除术（TURB）是治疗膀胱肿瘤的初始和关键步骤。该手术的目的是建立组织学诊断，确定肿瘤的分期和分级，并实现乳头状非肌肉浸润性肿瘤的完全切除。虽然TURB是一种经常进行的手术，但其结果受到高复发率和肿瘤分期不足风险的限制。最佳结果的主要先决条件是由训练有素的泌尿科医生系统和精心执行的程序。较小的肿瘤可整块切除;> 1 cm的肿瘤应分次单独切除。包括逼尿肌在内的深部切除对于正确分期至关重要。活检应取自所有提示原位癌（CIS）的区域，仅建议细胞学阳性或非乳头状肿瘤患者从正常粘膜活检。TURB应该用现代设备进行，包括新的望远镜和视频系统。此外，泌尿科医生应该意识到有前途的创新，包括新的成像技术，以及它们可能的好处。建议在初次切除时患有T1或高级别肿瘤的任何患者中，当病理学家报告标本不含肌肉时。在泌尿科医生不能确定初次切除是否完整的情况下，尤其是广泛和多发性肿瘤时，也应该考虑。(C)欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
Transurethral resection of the bladder (TURB) is the initial and critical step in the management of bladder tumours. The aim of the procedure is to establish the histologic diagnosis, determine the tumour stage and grade, and achieve complete removal of papillary non-muscle-invasive tumours. Although TURB is a frequently performed procedure, its results are limited by the high recurrence rate and by the risk of tumour understaging. The major prerequisite for optimal outcomes is a systematically and meticulously performed procedure by a well-trained urologist. Smaller tumours can be resected en bloc; tumours > 1 cm should be resected separately in fractions. Deep resection, including the detrusor muscle, is essential for correct staging, The biopsy should be taken from all areas suggestive of carcinoma in situ (CIS), and biopsies from normal-looking mucosa are recommended only in patients with positive cytology or non-papillary tumours. TURB should be performed with modern equipment, including new telescopes and video systems. Moreover, urologists should be aware of promising innovations, including new imaging techniques, and their possible benefits.Re-TUR can improve recurrence-free survival (RFS) and tumour staging. It is recommended in any patient with a T1 or high-grade tumour at initial resection and when the pathologist has reported that the specimen contained no muscle. It should also be considered in cases where the urologist is not sure that the initial resection was complete, especially in extensive and multiple tumours. (C) European Association of Urology. Published by Elsevier B.V. All rights reserved.