MP71-17 BIPOLAR TRANSURETHRAL RESECTION OF BLADDER TUMOR PROVIDES BETTER TISSUE FOR HISTOPATHOLOGY BUT HAS NO SUPERIOR EFFICACY AND SAFETY: A RANDOMIZED CONTROLLED TRIAL

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation II1 Apr 2018MP71-17 BIPOLAR TRANSURETHRAL RESECTION OF BLADDER TUMOR PROVIDES BETTER TISSUE FOR HISTOPATHOLOGY BUT HAS NO SUPERIOR EFFICACY AND SAFETY: A RANDOMIZED CONTROLLED TRIAL Pragatheeswarane Murugavaithianathan, Shrawan Singh, Sudheeer K Devana, Ravimohan Mavuduru, Santosh Kumar, Nandita Kakkar, and Arup Kumar Mandal Pragatheeswarane MurugavaithianathanPragatheeswarane Murugavaithianathan More articles by this author , Shrawan SinghShrawan Singh More articles by this author , Sudheeer K DevanaSudheeer K Devana More articles by this author , Ravimohan MavuduruRavimohan Mavuduru More articles by this author , Santosh KumarSantosh Kumar More articles by this author , Nandita KakkarNandita Kakkar More articles by this author , and Arup Kumar MandalArup Kumar Mandal More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2281AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Monopolar Transurethral resection of Bladder Tumor (TURBT) is considered the gold standard in the surgical treatment of non-muscle invasive bladder tumors. It is associated with obturator jerk, bladder perforation and charring of the tissue. The study was conducted to compare the above limitations of Monopolar TURBT (MTURBT) with Bipolar TURBT (BTURBT). METHODS The patients undergoing TURBT from July 2015 and October 2016 were randomized into two groups. Block randomization was performed with each block comprising of 10. Allocation was concealed in sealed envelope and implemented by operating room technician. Patients, pathologist and statistician were blinded regarding the allocation. All patients were operated under regional anaesthesia. BTURBT was performed by using a bipolar electrocautery with a 26 Fr resectoscope. For BTURBT power settings with automatic adjustment were used delivering 160 to 200 W for cutting and 100 to 120 W for coagulation. MTURBT was performed by using a standard 26 Fr resectoscope in the power setting with energy levels of 70 to 90 W for cutting and 30 to 60 W for coagulation. The intraoperative and postoperative events were noted. The TURBT chips were evaluated for both cautery artefacts as well as for thermal damage and were categorized from Grade 0 to 3 depending on degree of involvement of the specimen with artefact and thermal damage. RESULTS Total 75 patients underwent BTURBT and 70 underwent MTURBT. Both the groups were comparable for demographic profiles including age, gender, co morbidities, ASA grade, tumor size, tumor location and resection time. The incidence of obturator jerk was not significantly higher in MTURBT group {8/70 (11%) Vs 13/75 (17%), p = 0.325}. The bladder perforation rate was also not significantly higher (4/70 Vs 1/75, p = 0.192). The cautery artefacts was not observed in significantly high proportion of patients in bipolar group (22/75 Vs 3/70, p < 0.001). Grade 3 thermal damage was observed in significantly high proportion of patients in Monopolar group (12/70 Vs 3/75, p = 0.024). CONCLUSIONS Bipolar TURBT is not superior to monopolar TURBT and is not devoid of obturator jerk and bladder perforation. The less cautery artefacts and thermal damage may be an added advantage of Bipolar TURBT which may help the pathologist in better interpretation of histopathological grading and invasion of bladder tumor. However, its clinical significance is not established as yet. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e950 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Pragatheeswarane Murugavaithianathan More articles by this author Shrawan Singh More articles by this author Sudheeer K Devana More articles by this author Ravimohan Mavuduru More articles by this author Santosh Kumar More articles by this author Nandita Kakkar More articles by this author Arup Kumar Mandal More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...