Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Oct;41(10):2607-2615.
doi: 10.1007/s00345-023-04439-3. Epub 2023 May 27.

A 10-year renaissance of en bloc resection of bladder tumors (ERBT): Are we approaching the peak or is it back to the trough?

Dmitry Enikeev  1   2   3 , Andrey Morozov  4 , Anastasia Shpikina  4 , Harun Fajkovic  5   6 , Jack Baniel  7   8 , Thomas R W Herrmann  9   10   11
Affiliations
Review

A 10-year renaissance of en bloc resection of bladder tumors (ERBT): Are we approaching the peak or is it back to the trough?

Dmitry Enikeev et al. World J Urol. 2023 Oct.

Abstract

Background: The number of studies suggesting that en bloc resection of bladder tumor (ERBT) is superior to transurethral resection of bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC) management is growing. The aim of this review is to discuss the features of these procedures and to determine the prospects of en bloc in NMIBC management.

Materials and methods: We conducted a literature search using two databases (Medline and Scopus) and included any research which reported ERBT outcomes.

Results: The lasers with minimal tissue penetration depth are becoming the main tool for ERBT. Unfortunately, most of the systematic reviews continue to be characterized by high heterogeneity. However, recent studies indicate that ERBT may have the edge when it comes to the detrusor muscle rate and the quality of the histological specimen. ERBT may favor in terms of in-field relapse, but its rate in the studies varies greatly. As for out-field relapse-free survival, the data are still lacking. The strongest evidence supports that ERBT is superior to TURBT in complications rate (bladder perforation). ERBT is feasible irrespective to tumor size and location.

Conclusions: ERBT has gained in momentum with the increasingly widespread use of this kind of laser surgery. The introduction of novel sources (TFL and Thulium:YAG pulsed laser) will definitely affect how the field develops and will result in further improvements in safety and precision. The latest trials make us more certain in our belief that ERBT will be beneficial in terms of histological specimen quality, relapse rate and complications rate.

Keywords: Bladder cancer; En bloc; NMIBC; Resection.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Jones HC, Swinney J (1962) The treatment of tumours of the bladder by transurethral resection. Br J Urol 34(2):215–220. https://doi.org/10.1111/j.1464-410X.1962.tb06513.x - DOI - PubMed
    1. Herr H (2018) History of transurethral resection and fulguration of bladder tumors. In: Moran ME, Nakada SY, Patel SR (eds) The history of technologic advancements in urology. Springer International Publishing, Cham, pp 59–68. https://doi.org/10.1007/978-3-319-61691-9_6 - DOI
    1. Kawada T, Ebihara K, Suzuki T, Imai K, Yamanaka H (1997) A new technique for transurethral resection of bladder tumors: rotational tumor resection using a new arched electrode. J Urol. https://doi.org/10.1097/00005392-199706000-00057 - DOI - PubMed
    1. Das A, Gilling P, Fraundorfer M (1998) Holmium laser resection of bladder tumors (HoLRBT). Tech Urol 4(1):12–14. http://www.ncbi.nlm.nih.gov/pubmed/9568769
    1. Wolters M, Kramer MW, Becker JU, Christgen M, Nagele U, Imkamp F et al (2011) Tm:YAG laser en bloc mucosectomy for accurate staging of primary bladder cancer: early experience. World J Urol 29(4):429–432. https://doi.org/10.1007/s00345-011-0686-z - DOI - PubMed

LinkOut - more resources